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Oct, 29. 2015 1:15PM <br />No.0917 P. 1/1 <br />ELE�TRICAL PERMIT APPLICAT[ON � <br />C�TY OF EVERE�T PERMIT SERVIC�S <br />3200 C�DAR S7R��T, �V�RETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� y� <br />PaOJECT ADDRE55 <br />� '�� "-'�. <br />.� <br />Owner <br />Tenant <br />.�' <br />Elect cal Contractor <br />Mail Addross <br />Mail <br />Mail Address <br />.l � <br />tat icense umber (requirod) <br />�� <br />Proposed Use of Buflding <br />� <br />5quare Footage (If residential new construction, remodel or acidition) <br />t� <br />Number of devices (If low voltage) <br />Ciiy <br />� ��S d�a-���1 <br />Stalelzlp Phone <br />State/Zip Phone <br />City StatelZip ��v� Phone <br />����� � <br />Cify of Everett Business License Number (required) <br />� �� -� <br />Contract Price of Work <br />� <br />(i V �. <br />ontact erso /Contaci Number/Emaif <br />1�j3 `� � �-� <br />GC��,p c✓ C1� � G� <br />CITY OF EVERETT L�CAL SALES TAX CODE IS 3105 <br />I her�by certify that 1 have read and examined this applicativn and know the same to bo true and <br />correc�. Al! provlslons pf Idws �nd ordinances goverrring thls type of work wll! be completed <br />whefher specified herein or not. The �rantiny of a permit does not presume fo give authorlty to <br />violate or cancel the provisions of any other stafe or /oca/ law regulating construction or the <br />performsnce af cansfruction. �'hat l am authorized by the owner of this property to porfonn the <br />work for whrch application is msde and I comply wlfh the S�sfe Confrac�prs L�w 982i RCW and <br />296.200 WAC. <br />� U/ �-C1 I � 1-, <br />REvrsEo oaros�o7a <br />FEE <br />PERMIT# <br />►� ��� � -22� <br />