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Jan, 11. 2016_ 1 44P Sod Security Inc -_ No, 0214—P. 1:_ , <br /> ELECTRICAL PERMIT <br /> z APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, Eyj�FETT, WA 98201 `? <br /> 425-257-8810 -! FAX 425-2578857, ,.www.everettwa.org <br /> 1f�Cl� r ,,4t/E <br /> PROJECT ADDRESS `l Z: <br /> �5 - 55 � <br /> ~.- <br /> Owner Mall Address City -state/ZIP Phone <br /> Tenant Mail Address city ` StatelZip Phone <br /> S Leak w* 2aeo '( 2-5ff--30S5 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> V -7 1-3jj <br /> State License Number(required) City of Everett Business Licens Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage (C`f residential rieO construcfiort, remodel or addition) Contact Per on/Contact Number/Email <br /> (J <br /> Number of devices (If low voltage) <br /> Description of Work to Be pone, 1 r' <br /> Vt "e <br /> y�,C [,u. ?7i l 'U7— <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 5105 <br /> t hereby certify that I have read and examined this application and know the some to be true and <br /> correct- All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PFPMIT# <br /> violate or cancel the provisions of any otherstate or local law regulating construction or the I A <br /> performance of construction. That 1 am authorized by the owner.of this property to perform the <br /> work for which application is made and l comply with the State Cont r ctors Law 78.27 RCW and <br /> 296.20 WAC. <br /> Signature ��e <br /> ° <br /> i <br /> HE5 SED O"UIM4 <br />