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ELECT ICAL 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 /> ZBoO c l €uc.i Lt+ I-L �/ _E Ut -c 4-k L) 9e)1 cc <br /> PROJECT ADDRESS <br /> 1 'O0 iCX(��t� rb►-rL� AitatC Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> j( c E IeLtr t L.- 170 3cx 0°,46? 5e,6..}4- iA aemo 1c)4,--'136 526() <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> 2-0W^r *,f Uc� <br /> Proposed Use of Building Contract Price of Work <br /> �t�JoN �,CtIOE�/a,4t. 204. <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: C:.4 i vl C c .c*5 L" ,M+ CXC "t c`6Cc11'� <br /> „ A <br /> or .Sekk' , 4 L ko e x;sh-i ✓ c,; tf\ rc#0,A <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All 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 L� n D t <br /> performance of construction. That I am authorized by the owner of this property to perform theE `(�. Il <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC9Z/z71 —. <br /> S <br /> Sig ture Date <br /> REVISED 08/06/2014 <br />