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ELECTR AL PERMIT APP CATiON <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 />a �F� S w ��- -e. <br />.� f <br />PROJECT ADDRESS <br />f�Jf�2��T J!�'�oa.� �i7iSr2i�r '� �3o Co �.B y s9vl � ilf�2�TT ���243 <br />Owner Mail Address City State/Zip Phone <br />fV���7N /�/�J� cSC/'iGGG o?.3.3/ /��Sr1 J�]/� �✓�.�P�.7T l�oZfiC3 <br />T�nant Maii Address City State/Zip Phone <br />x�s <br />�L.L! M.� � / 6�S �O 9 �3 - �d'` .� T/9CGs»�9 9�l�G i �3 ''� y.3 3.��sZ3 <br />ElectriCal Contractor Mail Address City StatelZip Phone <br />�.LL! rr>�,� /D 7 7 G�S <br />State License Number <br />��rr!� o�E/�ddG. <br />Proposed Use of Building <br />.v �A <br />Square Footage (If residential new construction, remodel or addition) <br />.� <br />Number of devices (If low voltage) <br />�.a�O o0 <br />Contract Price of Work <br />� �✓il//� C�%�f�Y <br />Contact Person (Plan Review) <br />Description of Work to Be Done: /p��e,� G/� N�4J LtJ�%�-�- �IG-�v �O � X�ST/�G.. <br />IPO� Fi2 .1�i lrs�� Ci i2ccr i� .QY O.y-tttilS �` os/ �•v / S •�!X'�'�'� <br />6� w�sr �-t�✓A-rian� a�' S��oL �cc���,uo- Fi9���s- �t...-�-�»a � <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � �D <br />0 <br />I hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br />violate or cancel the provisions of any other state or local law regulating construction or the E r�� 3� I� <br />performance of construcfion. That 1 am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />REVISED 3/20/13 <br />