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11/06;'2015 4 : 21 PH FP. ' f j0001/0001 <br /> ELECTRICAL 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 /> 80i 57— 5 Iii/ z JG/G7-T PA 99263 <br /> PROJECT ADDRESS <br /> P re- c ��sa z°� /fl'/✓ ,ori/iJ✓s �:/�! �8/ 50�'�38 �5 7C� <br /> Owner Mall Address City State/Zip Phone <br /> Tenant Mall Address City State/Zip Phone <br /> t Di��'JG/C//yL /rte ,a7erz,.j /7I X79 e<esvi✓G77-)oi W.k 982!73 <br /> Electrical Contractor Mall Address City State/Zip Phone <br /> 33 /D <br /> State License Number(required) City of Everett Business License Number(required)- <br /> Proposed Use of Building Contract Price of Work <br /> Zi i e Cit" C'D"-1 <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Emall <br /> Number of devices(if low voltage) <br /> Description of Work to Be Done. 1peyyla-y-c :� &r 6J F;,a f 4 A17 L <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ` f1 <br /> I horeby certify that I have read and examined this application and know the samed I to be true anl/ <br /> correct, All provisions of laws and ordinances governing this type of work will be complotod <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 �' D <br /> performance of construction. That l am authorized by the owner of this property to perform the [� <br /> work for which application Is made and I comply with the State Contractors Lew 98.27 RCW and <br /> 296-200 WAC. <br /> AS- <br /> Signature Date <br /> REVISED 0SX642014 <br />