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From: � 08/�2015 17:56 #430 P.003/003 <br />ELECTRICAL PERMIT APPLICA`i10N <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 />� �d� �% � ��� � <br />PRQJECT ADDRESS <br />Maff Address <br />City <br />�or�c,��si" �� so� 1 a�ti�. t�.�sr PL N� �tood'��, <br />Electrical Contractor Mail Address City <br />�IORT�1 C—.� � 83 t� � <br />State License Number (required) <br />IProposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />tVumber of devices (If low voltage) <br />State/Zip <br />Stafe2ip <br />G�fA 48c�72 yz.5- <br />State/Zip <br />Phone <br />Phone <br />O_5D6 Q�# <br />City of Everett Business License Number (required) <br />������d�� <br />Contract Phce of Work <br />C.��.���'�o �� -���" C�/ <br />Contact Person/Contact Number/Emai! <br />��� `�--' �`��=Jes��� , G� <br />Description of Work to Be Done: �e I��e �a Q�d. ` � �+ �� I��t,� <br />��� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3405 <br />1 hereby certify fhat / have read and examined this application and know the same to be true and <br />correci. All provisions of laws and ordinances governing fhis fype of work wil/ be completed <br />whefher speci�ed here'n or not. 7he granting of a permif does not presume to give authority to <br />violafe or cancel the ovisioRs of any other state or loca! law requlating consiruction or the <br />perform ce of con uction. Thaf l am authorized by fhe owner of thrs property to perform the <br />work fo which a l' ation is made and I comply with the 5tafe Contractors Law 18.27 RCW and <br />296.2 I�AC. <br />'g-�-�5 <br />REVISFO 08/06/20f4 <br />FEE <br />�� 1� � �'� <br />r <br />PERMIT# <br />E � 5�'(�-�� <br />