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ELECT CAL PERMIT APP ICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />� <br />� j .;�'L,' ��� ��� .� �'-C_ <br />PROJECT ADDRESS <br />/-`� L �n , <br />C� r`�) C� ; C v'� /' �% � .�j ��?L� �` ���� 5'� L a�'�%' � �L� � ����,'r <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />S� + J <br />Electrical Contractor <br />Mail Address <br />Mail Address <br />.%�l�l GL L'��- � l � ,k�C�- <br />State License Number (required) <br />r <br />: S�-,zL-U< <� / i,r�'f - ���. 7`c f>"—� � � � <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />City <br />City <br />State/Zip <br />State/Zip <br />Phone <br />-2�-�� 1C <br />Phone <br />City of Everett Business License Number (required) <br />" /C1. �t e'�� <br />Contract Price of Work <br />.�/it�, l( �a ��a e/��'-L� j� //1 �:Z h U i i �[� <br />Contact Person/Contact Nu ber/Email <br />Description of Work to Be Done: ��/�'7`�� ��� ��'��J�`� ''�'� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions oflaws and ordrnances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume fo give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of fhis property fo perform the <br />work for which application is made and 1 comply with the Stafe Contractors Law 18.27 RCW and <br />296.200 WA� <br />� <br />ature <br />REVISED 08/06/2014 <br />7'�- Z �'- / <br />FEE <br />�l � <br />����� ..� <br />PERMIT# <br />E �SC'7-(%1 <br />