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425-252-1666 c.m. heating 12:03:04 11-06-2015 3!4 <br /> • • <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 l/ ---(4 —I S <br /> LI' 3I /--03-6 <br /> 33i1 ColD ' <br /> PROJECT ADDRESS <br /> 2OLCh "Pra-Vill rCtil S cuvAA..___Q - <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Cifsect,-6 ( mc- l'- occcuc 6)ex WA- Qg2D1 L 25 251 1 101 <br /> Electrical Contra or Mail Address City State/Zip Phone <br /> amt M 4 711 bre b 1 Co p q S <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> y2 thbL q-25 2561 606:DGE <br /> Square Footage (If residential new construction, remodel or addition) ontact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: 12a_��_, I )TCl+ cl ftS i a a CQ <br /> 9 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 t5 bob <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 /> v✓hetherspecified 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 1 am authorized by the owner of this property to perform the E lCj ( f D Vo <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 410 � ((�t f' � s I 5 <br /> Signatur Date <br /> REVISED OEAE12014 <br />