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• • <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 k 5 0tai <br /> 16 CC O L l3, 4L -( <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> auc (!�S �1e ( — S S t� ✓���� <br /> �' G :irk w 8158 <br /> 1 <br /> Tenant -� Mail Address City State/Zip Phone <br /> < ec7,Q /�c S�l �► c N-e5TNLr LH ZW1S- 3 Sq <br /> CALA6R14 E CAHAmv /S[ A-N► 14 e1y ;ta. 99 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> CALABr OcSI L1/11 t <br /> State License Number(required) City of vere Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> 9e -1/vis LL 3S9 ZZgy <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> C ALA ;3/i; <br /> . roM <br /> Number of devices (If low voltage) <br /> • <br /> Description of Work to Be Done: g'( La At{ C / C u 1 Ti (.2) A n P (�/•iC L '1 / 7l (6) <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 p 0 '5 o <br /> I hereby certify that I 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 I am authorized by the owner of this property to perform the t 010(,1- - 1 -7 <br /> work for which application is made and I comply with the State Contractors Law 18,27 RCW and 6 <br /> 296.200 WAC. <br /> y / 2 / ir <br /> Signature Date <br /> REVISED 08/06/2014 <br />