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_r � <br /> ' <br /> ELECTRICAL PERMIT APPL[CATlON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettv✓a.org <br /> -- --- ------ - -- - -- -- - <br /> __ __ _ ---- - -- - <br /> ____ _- <br /> 2 �vy ����b ��� <br /> PF�Q.lECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> �.2 J <br /> � nro - Ts le �ODi� CD`Di° a�f04 lriP��9�l� �1/� �t/,c�P�;T �✓�1 9�.?D( a59-37�? <br /> Tenant Maii Address City Stale/Zip Phone <br /> i <br /> ��c�!L �..EL T1?t� .��G�t k���',k°.G—bE��. l�fr"� E U�.�-�r' L.�'t— �`��U i �t.1 S����'�—i?�}� <br /> Eiectricai Contrac'tor Mail Address City StatelZip Phone <br /> l��t��.�E� ��t�€�� � � � � ��f <br /> State License Number(required) City of Everett Business License Number(required) <br /> y� .o <br /> ,{, y s� - <br /> Proposed Use of Building Contract Price of Work <br /> �i�r.i .S i�itf�AES .�F�U `�.�s�-L.��l <br /> �S�L'VGKS�t�r..hELEECrcN1L.CGi^✓l <br /> Square Footage(If residential new construction, remodel or addition) Contact PersonlContact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done� /7�� C��°G(•�.t T �'D1Q. �E.F�,�d-G.Q p?�� �!y <br /> ��L 1 <br /> FEE <br /> CfTY OF EVERETT LOCAL SALES TAX CODE !S 31Q5 �� _�� � <br /> 1 hereby certify that I have read and examined#his application and Y.now the same to be true and <br /> correcf. A!1 provisions of laws and ordinances goVe;n�ng fhis type of work wrll be completed <br /> whether specrfied herein or not. The granfing of a pennit does not presume to give authority to PERMIT# <br /> vrolate or cance!the provisions of any other state or local law regulating construction or the � �� � � ` O�� <br /> pertDrmance of construction. Thaf!am authorized 6y the owner of this property to perform the <br /> work for which application is made and/comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC <br /> ti /j 7— l� <br /> Signature Date <br /> REVfSED 06/062014 <br />