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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.gov <br /> X2920 vol1N_iA1- (lye: <br /> PROJECT ADDRESS <br /> Roarati" �iii��,TT Po 60 `�3`� i v �r�� WEI `(R20 , ,-12c) 2bci-310l <br /> Owner Mail Address City tate/Zip Phone <br /> t� It t I \ <br /> Tenant Mail Address City State/Zip Phone <br /> i-0y Ca R o()P2 o N vv P>oC" 5k-. t0FW h07 to i aN <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> r�Y�ti��C�• ���, <br /> 3H-113-(e <br /> State License Number(required) City of Everett Business License Number(required) <br /> Pr��r 5 I � 200 <br /> Proposed Use of Building Contract Price of Work <br /> C1-17) I-tE LECGJ.26w'''IO2>10% <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Cdntact Number/Email <br /> H <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: IN 5Tl:1 t^t^1 Ni (u (3U OD CAM l_1pi ft "t \\i-� iNiG 1 DRi <br /> AND NI powG CONN r'_CT'iokic, <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 5-0 <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 E 1507 -- V l S' <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Date <br /> REVISED 08/062014 <br />