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425-252-1666 CM HEATING <br />10:15:33 a.rn. 09-22-2015 6 /7 <br />_. . __ .._ .._......,. __...._._._ _. __...._..__._ <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMiT SERVICES <br />3200 CEDAR STREET, EVER�TT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� �a �� � �r �� <br />PROJECT ADDRESS <br />'(��rR<BA��A GF�LL{�C �IeR �c`�-1 �l� S� S� �1e�Re"�' �JA���b� �p_��[. (� <br />OWne� I41aI! Address City State/Zip Phone <br />Tenant <br />Electrical Contractor <br />Mail Address <br />Mail Address <br />_ Cm�M�+g�7 b� <br />State License Number (required) <br />Proposed Use of Bullding <br />Square Footage (If residential new construction, remodel or addition) <br />City <br />Clty <br />StalelZip <br />Q ( Z� <br />Stale2ip <br />Phone <br />���� <br />Phone <br />o' c�oa� <br />City oF Everett Business License Number (required) <br />� �� <br />Contract Price of Wark <br />�f�'�� �til�S ���5��-�/ <br />Contact PersonlCantact NumberlEmall <br />��e�����.�M <br />Number of dQvices (If low voltage) <br />Description of Work to Be Done: � 1� D/� ��L�'t'� ��,� �C�, l� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />l hereby certity that I have read and examined this application and know the same to be true and <br />carre�t. All provisions oflaws and ordinances goveming this type of worfc will be completed <br />whetherspecified hsreln o�not. The gr,�nting of a permit does not presume to give aufhority to <br />violate orcancel ihe provisions of any ofher sfate or/ocal law regu/nfing consiruction or the <br />perfonnance of constrt�cfion. That ! am authorized by the ownerof th/s property to perform the <br />�vorit for which ppplicafion is made and I comply with thQ State Confractors Law �8.27 RCW and <br />296. 200 INAC. <br />AEVISED 09.D6/201 a <br />FEE <br />�0 � <br />PERMIT# <br />E (�0�- ��� <br />