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ELECTRICAL PERMIT fit PUGATIr N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRLL f, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257.8857 - wwweverettwa.org <br />jo/� N4`704 >/ <br />PROJECTADDRESS <br />�v f� of co>Gs ti goo �r�.� SS r t� �.�7, k.� ��106 r�s 38� - �0. <br />Owner Mail Address City State/Zip Phone <br />Tenant Mall Addreso City State/Zip Phone <br />rtr a ssn Cry t� SS�J' /�l9 y' <br />Electrical Contractor Mail Address <br />ro = iR Sc Sell c <br />State License Number <br />Ca/�tr aai <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (It low voltage) <br />COY Slalerlip Phone <br />Description of Work to Be Done: -Z;e Z4 // el, I-fA/ S r S h <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />�� &/btr/, r <br />Contract Price of Work <br />j OF <br />Contact Person (Plan Review) <br />I hereby certify that I have read and examined this application and know tire same to be true and <br />correct. Alf provisions or 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 <br />violate or cancel the provisions or any other state or local law regulating construction or the <br />performance of construction. That I 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 Lew 16.27 RCW and <br />296.20VPAC. <br />FEE <br />-5TN <br />PERMIT# <br />E l q 0(p -1 Qg <br />