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0 <br /> ELECA ICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 — t4,/iv i,,(,) ua- d V <br /> r-644e ve--re-e-j` wd-i qe V <br /> -7 pc <br /> PROJECT ADDRESS <br /> Cj <br /> Owner Mail Address <br /> City State/Zip Phone <br /> J-Irv�6erL <br /> Tenant Mail Address City State/Zip Phone <br /> lod -,Duuki?- k- PG, 133 K tzf L.#A <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> CC) <br /> Proposed Use of Building Contract Price of Work <br /> 71-C-,-WT -,jjLi <br /> _a�q jj T -V <br /> Square Footage(if residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low—voltage) <br /> Description of Work to Be Done: V i Pj <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE 13 3105 <br /> hereby certify that/have read and examined this application and know the same 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 PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That If am authorized by the owner of this property to perform the E 11,50q <br /> work for which application is made and comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Date ' <br /> REVISED 0810612014 <br />