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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 />�o�G I 3�t�' �vP 1n1. , S�n;�P I�jO E�P�re+��W� �t�a6� <br />PROJECT ADDRESS <br />Owner <br />(l�rh�� �. <br />Tenant <br />Mail Address <br />�cir,�1 �D��� ���h <br />7�r <br />�G �j Mail Address <br />r���.��.,,� <br />City <br />� P �� 5h;ip 1�4 <br />City <br />71:� <br />EI���C�,r�acto���� �._,,,,�„pMailAddress City <br />' �(�V\ <br />�Od �+ %i�0� "' �OS`�-��d la�o2� 201(0 <br />State License Number (required) <br />Proposed Use of Building <br />State/Zip <br />c �� <br />State/Zip <br />Phone <br />So3- <br />3 �taq - <br />Phone <br />Phone <br />05't� �-� <br />City of Everett Business License Number (required) <br />��� � <br />Contract Price of Work <br />}I,a�� Wscq�,t/�53��55"�447/ <br />Square Footage (If residential new construction, remodel or addition) Contact Person o act Number/Email � <br />1�w�igh� <br />� � o�; <br />Number of devices (If low voltage) <br />Description of Work to Be Done: � �C� K� r�► h '� �n0 � P °' `� � �� C� r C KI � S � r d� <br />C1 Pvhavc }V � l��j� ow►�t'r IV ��v�rd r�- eq�; p,n�e��' . Ez�'�v�,t�i�..G� C'+ �� +P <br />�; p vH d+( yl $'� vJ0 Y' <br />p�'► c�. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�w i- �U .�ov k� <br />I hereby certify that l have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing fhis type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That 1 am aufhorized by the owner of this property to perform the <br />work for which application is ma mply with the Sfate Contractors Law 18.27 RCW and <br />296.200 WAC. , <br />��l � f S <br />REVISED 08/06/2014 <br />��o�� a.v�vav <br />FEE <br />������ <br />PERMIT# <br />EL�D�� I�I <br />� �o� <br />