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01 � � 09:51:52 09-07-2013 1/1 <br />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 />��P ��`�`ir�l1_ - �/��e��� t�Ll <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />City <br />State/Zip Phone <br />�� 1%%�� � <br />Tenant Mail Address City State2ip Phone <br />�zav 9 Z/ - �o � <br />�„ � SGc�>�c/�- �' ���s�r� 1���7zz3 �f z �� <br />Electrical ContraCtor Mail Address City State2ip Phone <br />�/��,�T �8�3�5 <br />State License Number <br />��vsri� � /%r�� L S��.e� <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />7�� <br />Con�act Price of <br />�v <br />ntacf Person (Plan Review) <br />�7/- 2G.� - �� 4� �-P�f <br />�^c� ch c� Cacfi �art i.� �• <br />�c�m <br />��l-�s--yz�8-�� <br />Description of Work to Be Done: .�(1D U!3$S f�il�I i0/L� -�(SCU� i?/'1 �LT ei�(S% /11 G �/`Q�'IC/� <br />A...,,._. i..2 .� ...--- - - �. .. - - - • - - - ��. . - <br />CITY OF EVERE7T LOCAL SALES TAX CODE fS 3105 <br />l here6y certify fhat 1 have read and examined this applicafron and know fhe same to be trr�e and <br />correct All provisions of laws and ordinances goveming this type of work will be completed <br />whether specified herein or not. The granting of a permif does not presume to give auihority to <br />violate or cancel the provisions of any other state orlocal law regulafing consfruction or the <br />performance of construciion. That I am authorized by the owner of this property to perform fhe <br />woric for which applrcation is made and I comply with the State Confraciors Law 98.27 RCW and <br />296.200 VYAC. ., � <br />- � /3 <br />FEE <br />�s-v� <br />PERMIT# <br />E � �30� - 0 35 <br />� l(�f) �£P �/f �i�i2lo � � <br />C�� c� L� /�-h°� �1 �i �i <br />c�nAinc� D �� 8 <br />/ <br />