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• i <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.gov <br />6&07 EVI2.RC;Hfi:EiiN VJAY <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />4V;`�LU(�lEEN'SC010G1N�l.M1A0�7�R0�4D.ViSlrloa(?DEc(1FIELD.�1.600i5 f;-t7-23a-r.t�e5 <br />Mail Address <br />Mail Address <br />City <br />f;��"�11=.:1S OVJNF:fi <br />City <br />U.F. ELECTTiIC. 1NG Pt7 80X 720!i �7�At;OR4 �. 4NA 9841 7 2iJ-'>7G-;4701 <br />Electrical Contractor Mail Address <br />(aF F::...�I'07 �C)9 <br />State License Number (required) <br />���o car�s�.n_r,^;ric��v E�oo�,^ iv Fxisrinc s�orj� <br />Proposed Use of Building <br />City <br />State/Zip <br />State/Zip <br />State/Zip <br />G38S�sy <br />Phone <br />Phone <br />Phone <br />City of Everett Business License Number (required) <br />sz., :, c <br />Contract Price of Work <br />'10; fi:.1UF�(iF t I:.F��i� (RpWROX.I AtiD" F'stN-LE'I '. ;-r,On-iy�;) 1�11JYC-1)F'EtFC;TF;IG.NET <br />Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br />Number of devices (If low voltage) <br />rv>rn�_i.. r�E::vJ i.icrrrir�c.., E=i_u���,aoi onNr.� nur>t.�::x r�F::c.;r:i>rnc;i_f::s iv N�:.v�r, sMni_i_corvsi.;i. r;<nov r;t:�o�n <br />Description of Work to Be Done: <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 1 <br />� � Z��� � <br />I hereby certify that I have read and examined this application and know the same to be true a�d <br />correct. All provisions of laws and ordrnances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authorrty to PERMIT# <br />violate or cancel the provisions of any ofher state or local law regulating construction or the <br />performance of construction. That 1 am authorized by t e owner of this property to perform the E I��� I�� <br />work for which application is made and I comply with� State Contractors Law 18.27 RCW and <br />296. 200 WA C. <br />Date <br />REVISED 08/O6/2014 <br />