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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 /> ------------ --- - --- <br /> 3ak Pi ith / t' <br /> PROJECT ADDRESS <br /> 6-L4Gl i,2 62MrVIES 31101 /tedJv,rcG l4LC. &if 6ved40-i Wf Not <br /> Owner Mail Address City State/Zip Phone <br /> 1440 iiilDA(.ST"*Rs .33Q4 "Aidz Ave Lv' ee'ir L✓/1- 1101>I '125-75v1;.lgS <br /> Tenant Mail Address City State/Zip Phone <br /> I I <br /> nPI4L ELEc-Ale_ _S44.O6i PLOP'../.1-ALL EIQ Euz_Lzir k4i- ti loi LJ15-25'1-flIt, <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 10A14LLEt c'i1i..L8 0 1 614 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building ContractryPrice of Work <br /> ii►o�c S e'CtiakES .3 LLb --1.1p 1-D5-it <br /> cIsi-c.o.e.vsC .E�1c�TriL.4.apv, <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) / `� <br /> Description of Work to Be Done: NE.� 6 0 r l i"(.✓' .5 CR/I G E. <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 t5 -, SO <br /> - I hereby-certify-that I have-read and examined this application and knowthe same--to be true and * �( <br /> correct. Al/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 PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the E111-045 <br /> performance of construction. That I am authorized by the owner of this property to perform the b <br /> work for which application is made and/comply with the State Contractors Law 18.27 RCW and <br /> 296.200 W . <br /> Signature Date <br /> REVISED 08/06/2014 <br />