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� � <br />ELE:CTRICAL 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 />G G� <br />�.� l� �7 y s� S� �r�l�� 'i i <br />PROJECT ADDRESS <br />A P� ��� �r�i,��'i iE5 ��c <br />Owner . � Mail Address City <br />Tenant <br />�AJ�Ir�'I'�i (t��L'iQjC. <br />Electrical Contractor <br />Mail Address <br />;_R i/� C�' <br />Mail Address <br />i,(,� = i,ri n_ S 9�i Z.� .� —� <br />State License Number (required) <br />Proposed Use of Building <br />�' l <br />L D �v <br />Square Footage (If reside tial new construction, remodel or addition) <br />Number of devices (If low voltage) <br />City <br />� c,�� 5�r, <br />City <br />State/Zip <br />State/Zip <br />9 �'c>'� ,� <br />State/Zip <br />Phone <br />Phone <br />y7,� <br />Phone <br />JyL/y�� <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />Contact Person/Contact Number/Email <br />Description of Work to Be DonE:: ���� ��r C1 iV (;- � i� I S`; 1�� <�'(�� d� 5� R j// C�C <br />� L f.v I I? ! i(,� � t� I� D i.-{-J �> >'� <br />CITY OF EVERETT LOCAL S��LES TAX CODE IS 3105 <br />I hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordrnances goveming this type of work will be completed <br />whefher 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 /oca/ law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which application is m��de and I comply wrth fhe State Contractors Law 18.27 RCW and <br />296.200 WAC. .. <br />re <br />REVI SED 08/06/2014 <br />�'S/ �2 / l5 <br />uate <br />FEE <br />g ��U <br />PERMIT# <br />E�5c�5 . I�f� <br />