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05/03/2015 07:38 3604740126 DONNELSON ELECTRIC INC #3400 P.002 /002 <br /> l ' <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 /> Q0 � <br /> —PROJECT ADDRESS <br /> I _ <br /> � s 1 i �F3 Z y✓�G. �i�EO �/L'c� t/��e �' l.iA. l �'zo✓ �,'z�- a � <br /> Owner Mail Address City StateJZip <br /> Phone <br /> Tenant Mail Address City StatefZip Phone <br /> Od ° <br /> IJ'� A/- ® �-+,/ ,�C A" SVA.. Iz'Z2� .3'"``t`✓ '$`?ZG <br /> Eiectiical Contractor Mail Address City State/zip Phone <br /> I <br /> I Els®44'd FZ <br /> State License Number(required) City of Everett Business License Number(required) f <br /> ` Pr posed Use of Building Contract Price of Work <br /> i <br /> ttaCt <br /> �-i 2S Z3 �zF`� 3Square Footage (If residential new construction,remodel or addition) Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> g ) <br /> Description of Work to 6e Dore: -C4-JJ CC4,-t <br /> i <br /> I <br /> I <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �! i <br /> !hereby certify that/have read and examined this application and know the same to be true and i <br /> correct. All provisions of laws and ordinances governing this type of work wN 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 I am authorized bX the owner of this property to perform the i <br /> I work for which application i e and!comply with the State Contractors Law 16,27 RCW and / I I <br /> 296.200 WAC_ E <br /> i _. , <br /> i <br /> Signature oat <br /> I <br /> i <br /> Ii RF/�oero6/2orc <br />