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ELECTRIC�iL PERMIT �►PPLIC�►1"1 <br />�CITY �F EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />�6'0 � V� �����;'lfe� ,�%�� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />��L�e� v� <br />�1��� �'����,� 1�c ���i� �a�;�� f� <br />Electr al Contractor Mail Address <br />s•h�}F-�z�86�a� . <br />��1 _ G� �� 3i� — ���� <br />State License Number (required) <br />� ' � � <br />Proposed Use of Building <br />n1OO S�� <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />�� "%7� , � <br />I; <br />� <br />City <br />City <br />� <br />������ <br />City <br />State/Zip <br />State/Zip <br />r" � <br />State/Zip <br />Phone <br />Phone <br />���� <br />Phone <br />City of Everett Business License Number (required) <br />� � ���� d L�, <br />Contract Price of Work <br />, <br />�.c�� J , �C � J��-�� �iyl <br />ntact e so Contact Num /Email <br />JI/�'�,,,,� 1�% '�,`��' � ��rL�� <br />�y %%�,'.� �;�,��' <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that f have read and examined this application and know the same fo be frue and <br />correct. AlI 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 authorify to <br />violafe or cancel the provisions of any other sfafe or local law regulating construcfion or fhe <br />performance of construction. That 1 am aufhorized by the owner of this prope�ty to perform the <br />work for which application is m�and�comply with the Sfafe Contractors Law 18.27 RCW and <br />296.200 Vl/A C'/. „ / , <br />��/�v//� <br />REVISED OB/O6/2014 <br />FEE <br />��� <br />PERMIT# <br />E ��r0- �s� <br />