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r-1 <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 <br />16 I -5- 7 S+L Sf S CU <br />PROJECT ADDRESS <br />Evef�+� TpGk Per k lot E Ilr ��-� AuE w 33c3 Sal 4► , R S c IR <br />Owner Mail Address City State/Zip Phone <br />ije.{5i#� --Fecr 1&15- �s�� SrtSw 5tj(4-e- T---ueyCP- Wk 43),C)l <br />Tenant v Mail Address City State/Zip Phone <br />N\ep-�-- uA,16, 2lx2�aIIwYq�ts�+� �.fiURr '3 360-YN1 132� <br />Electrical Contr ctor Wil Address City State/Zip Phone <br />NAQyeFS 60 (2c y <br />State License Number (required) City of Everett Business License Number (required) <br />Proposed Use of Building Contract Price of Work <br />Ts(,(( ���� 360-y2q-1SZ <br />Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br />Number of devices (If low voltage) <br />Description of Work to Be Done: e�l4C tX<,5���� mo-1 u wt-e.� -StILA <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 50 <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 performance of construction. That / am authorized by the owner of this property to perform the E 1410 r35 <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 0810612014 <br />