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ELEC1'RICAL. PERf�lli APF'LICATIOfV <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�'��' SE �V�'1��T-i M�,i.L �I Ay 5��� iE I bD E�('ET�T l�v-� �`�Zt��' <br />PROJECT ADDRESS <br />Owner <br />C iTy �Ni�Elz51T <br />Tenant <br />Mail Address <br />� 2� W(�I.L S <br />il Address <br />City State/Zip <br />ee� S��'�-�kle 1�I� <br />City <br />Phone <br />z c:�G� � 3 ( .- � `j <br />��� <br />State/Zip � � f �Z ( Phone <br />i�nv'P�t��f��c ��bio �,�isv�L Si�S"►�r��S (Z�DYv�o,v� '�NA 9�o�Z <br />Electrical Contractor Mail Address City State/Zip Phone <br />� �� ��� � G� �-�^ � L N� '� Z s�1�� `� i <br />1����P� N A�1 8�'�� �tz G � � <br />State License Number (required) <br />CLp�ss�z�.�orti�,s -- �' i a�v �Pti^� ��c�r�r s <br />Proposed Use of Building �� nl S�"A I,�r� T o(� <br />�% f1 O C� SC�R FT � <br />Square Footage (If residential new construction, remodel or addition) <br />� <br />Number of devices (If low voltage) <br />d������ <br />City of Everett Business License Number (required) <br />� �t�oo <br />Contract Price of Work <br />2�y Cr��t��rr^�� 2r��-..Z3y_��s� <br />Contact P rson/Contact Number/Email <br />Description of Work to Be Done: C�J'�SS(ZetJl�'� Y v' '�Y�b �'V�t�1�C�D�fS �E�'>•-�kl.l ��f��Y�1 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <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 <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 fhis property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. _ <br />Z �D <br />gnature <br />REVI SED 08/O6/2014 <br />FEE <br />������b <br />PERMIT# <br />E�`��6���� <br />