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02/17/2016 09: 03 4254054320 HILL ELECTRIC PAGE 02/02 <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 /> I O'a E <br /> PROJECT ADDRESS <br /> o c7 I�' re _v� A-- qg�g <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mall AddreSS City state/Zip Phone <br /> I� 1=-fecF, ,c-Cv P® 3o.x f015" Vodc,w'(f c vjA-'?90-7a yahK?5 q3D <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 141LLC-6, <br /> State License Number(required) City of Everett Business License Number(required) <br /> Vj --?-r-4�SG _ I C�b0 <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) II <br /> Description of Work to Be Done: t OCs 'Q_ ® y�� GQ+ t r. ,��G 6:7 VV ytc� c� <br /> L'o <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 # �� l <br /> I hereby certify that 1 have read and examined this application and know the same to be true 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 pennit 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 <br /> performance of construction. That 1 am authorized by the owner of this property to perform the E 102 <br /> work for which application is made and l comply with the state Contractors Law 98.27 RCW and <br /> 296.200 WAC. F <br /> ignature Date <br /> REVISED 08/)&2014 <br />