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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 />I l� I� 7�� S-r- �;,�/ <br />-; T� it-� I.t�tr��� (��,s-f, ti:, �t 1,I <br />PROJECT ADDRESS <br />,�(T/��i <br />l 3C�C�: <br />/�,� <br />' �/C7 �� 1 ��C� Y iLLC. <br />Mail Address <br />C�� I��� 7���- 3�>� <br />���' � z 3 i �IC��; -��.37�� <br />State/Zip Phone <br />_� T�T jr � I, r, I I�,�� ;� tc jC� I 5 t�''S�. S. �: J"�c,�� �l, ��-�� �Y�c�� ���.��_5 ��' _��� , <br />,�c�, <br />c <br />Tenant Mail Address City State/Zip Phone <br />r �, i ( ( ��� � <br />`�, -%`,t;li. .l i iL : i��i� '�� �Lcx6uCb�c� ��L��. �;�C�.� ��/1S ) ,S,Sc�' - L/L',}(U <br />Electrical ContraCtor Mail Address �—City State/Zip � Phone <br />����11;� L�- � 3 � 1� 1-� <br />State License Number <br />.� `, -t ; � - i�. � �.c�uc.iif, u <br />Pr osed Use of Buildin <br />� � � � �+� ',: { t <br />Squa�age (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />c r°, ( ��u �lw <br />�^. - �� p <br />I �,1L�L <br />Contract Price of Work <br />.Sc � C�� i��� <br />Contact Person (Plan Review) <br />,,° r_ � � r� � n,w�+ �-- <br />�<(���kf� �� zk� C������ �u� � j �� i�, ` � � �,s � f t`�r <br />� C-��t� �T��,r�i�S . i �5.'��,�, a�ci�- 2 ��i' L!)b � / ��+�t'- <br />�',-�"C /���'`%� %��c-l: ��������,-i .,, : l(�L C LfLr`;�`L� u�, �{-; u,� �, .(tj �i�'W'�� � r.�'�y"�S, <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 have read and examined this appiication and know the same fo be frue and <br />correct. Al/ provisions of laws and ordinances goveming this type of woric will be completed <br />whether specified herein or nof. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other stafe or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />worlc for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />2 / /�5 %�c=/ <br />REVISED 320/13 <br />FEE <br />.��� � �' <br />PERMIT# <br />E � �--� � �- — � (� d-- <br />