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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 C�_ (��`C �,�r l� <br />PROJECT ADDRESS <br />S �.� � � � r�,�.� n �� r� � � , �.� � Z-,�}-� <�,�� (�Y ,411 t: , i_.V �:��-'t"`r , ��A � � �� �_ l <br />Owner <br />Mail Address <br />City <br />State/Zip Phone <br />��C�S2.. <br />,����`T� nai�� �, i�'� 1 �z� i �J� �2tiD �,��.`� , S� � ��bn�`-�Ji�, �.�,� <br />Tenant Mail Address City State/Zip Phone <br />(Z�-�) <br />�,;�1 U� �-t.�..�2i c.>�,-t., �c� ri r�s� ��� ��x `� 1 t �� L�,-c��,�a� �uf� �� �� � 8�� ..93� <br />Electrical Contractor Mail Address City State/Zip Phone <br />�f�{(�,L 1��9Sp�"7 <br />State License Number (required) <br />t�l��� C�t�tJt>>'�T�»2 k'f L-�C�ST►i��-(_, �.�t ��2irLLs� <br />Proposed Use of Building C-C)h I� (.i 1v1 C,iQ�1 l l.�V�� �C� 11,1`�`/ <br />Square Footage (If residential new construction, remodel or addition) <br />�"Z) 2�% � I`'� P�'�t�Z�f l c� t=� <br />Number of devices (If low voltage) <br />City of Everett Business License Number (required) <br />Z., r�� c� <br />Contract Price of Work <br />�1°� l 1.�, � P I� ifi LL--s -��>[,., �� •i <br />Contact Person/Contact Number/Er�t ail <br />(� N- I(.. C... l j= . jL. l� Z, l� S C� (_� �� Y-. (_.D o � <br />Description of Work to Be Done: � I� ��� l.._�- 1� S`T�'�`'pr�ii L.rl L' �2-�t �,�-?�L`f L� l�n.,�ro�- ��� � <br />� t%�.� C�.e�►'v'ul:..� �1� c�l.�� , 11v �T7sLi-> ��-� � t�\,v "u� .�� �'I C' j L12V I C,C �.� Y U <br />f�i=: l�v`�C� G ��-�-�t'� t NS"� �.--x,ic-r � s�-�, t��v�t ��-- s�_.t.� ►�-c��. . <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />l hereby certify that I have read and examined this application and know fhe same to be true and <br />correct. All provisions of laws and ordinances goveming 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 <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 <br />work for whicl� application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />� <br />C> , y `J I <br />REVISED 08/06/2014 <br />FEE <br />���5� <br />PERMIT# <br />E;�Dg- �(�� <br />� <br />