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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 />F� � �?�' L/j h� �. � l O�% <br />��� � � � i � ��� i�u �',Lr�C 12 <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />Mail Address <br />City <br />State/Zip Phone <br />ZyL �"— <br />�✓ ����. �C�,r,�:i c�we. P C� ,�� x Z 1 17 Ly�te�J �'h��r'�. %����- �'�Z_ 7C. S�-1 <br />Electrical ContraCtor Mail Address City State/Zip Phone <br />�� � L� �t �. `� 7�,��; <br />State License Number (required) <br />1Z��SZ r� +� ,:� c.,� <br />Proposed Use of Building <br />G� � G <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />, <br />� � f \�..� I � / <br />Cit�f Everett Business License Number (required) <br />�i,�� � � <br />Contract Price of Work <br />�1�� ZC.1�- %��-%�'� �. <br />Contact Person/Contact Number/Email <br />�. � 5 Tn �. � �� ��: �.��r.p r� �� L-� G-h TS' <br />Description of Work to Be Done: � <br />��- P� l���� �� �' <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of /aws 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 />pertormance of construction. That 1 am authorized by the owner of this 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 />re <br />REVISED 08/06/2014 <br />� � � �- ,s- <br />uate <br />FEE <br />���� p', <br />i/ <br />PERMIT# <br />E d � ��j - riv"? ;�c>, <br />