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425-252-1666 CM HEATING <br />02:22:17 p.m. 05-18-2015 3/4 <br />ELECTRICAL PERMIT APPLiCATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR $TREET; EVERETT, WA 98209 <br />425-257-8810 - FAX 425-257-6857 —www.everetfwa.org <br />yD 5 �l7 `}`'' S� 5� <br />PROJECT ADORESS <br />r�` �'1G� f o� � ZD 79! slo8�-- <br />5�- P�SS F l�� 1�1��t 3 �z5 <br />�wnef Mail Address City Stale/Zip Phone <br />Tenarlt Maii Address City 5tate2lp Phone <br />Cf�l l�eatinG l�. 1�15 �iY'[xidu�c�u G1�,r�tt� 1N� q8�o� �z� 259 C���� <br />Electricaf ContrBctor- Mail Address ' Clty S4ate/Zip Phone <br />Cm��g�7 b� <br />State License NUmber (reqilired) <br />Proposed Use of Building <br />5quare Footage (If residentiai new construction, temodel or addition) <br />Num6er of deyices (if !ow voltage,) <br />Description of W�rk to Be Done: <br />EOI (004� <br />City of Eiie�eft Business License Num6er (required) <br />z�a ' <br />Contract Price of Work <br />' �l� <br />Co act Person/Contact Number/Emali <br />CITY OF EVERE"Cl' LOCAL SALES TAX CODE IS 3105 <br />I here6y certify thai l have read and examined fhfs applicaflon and knoW fhe same fo 6e true and <br />correct. All piavisions of laws and oralinancea goveming thls type of work wlll be completed <br />whetherspeci�ed herein ornot. The granting of a permit does not presume io grve authorify io <br />violaEe orcanc�l the provisions of any dthersfate or/oca! law regulafing constnrcfion orthe <br />perf"ormance of construction. �That I am aufhorized by fhe oi+vner of this property to perfoiin the <br />wortc for which applicafion is made and 1 comp/y with the State Contractors Law.18.27 RCW and <br />296.200 WAC. <br />REVISED OBi9B/2014 <br />FEE <br />� �D.oa <br />PERMiT# <br />E �� b5^-� � D� <br />