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0 <br /> ELECT CAL PERMIT APPLICATION <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 /> j g sic) S.�- S)e rr-+ j '902V <br /> PROJECppT ADDRESS pp <br /> ced <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> 41A `X&OO) 206—Y36--,S2'C) <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> 2ooco" <br /> Proposed Use of Building cc Contract Price of Work n <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) r_ <br /> Description of Work to Be Done: 13LV1 � G f i (�✓1 Cs1�+�P_T 5 a Pik <br /> �2lOc (c art <,;am t"ja l wD.-- i b-r--E- OKI o id <br /> l oca-k o ' S cb no-I- 4--0 b(o L 1 a-k cv � r-nro m A mnVr_S <br /> ` FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 4 �61 <br /> I hereby certify that I 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 worts 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 <br /> performance of construction. That l am authorized by the owner of this property to perform the E (�O � <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Sig a ure ate <br /> REVISED 08/06/2014 <br />