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�I <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 />& ) 308-06� <br />3 10 ►j Ca-61 �d <br />PROJECT ADDRESS <br />310 ►J Coskzst QJ � WA y2s> �t2 --40& <br />Owner <br />Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />IF (LL .r t Z522 P-ux� &* -I'l302 E\F- lM qno I '{251303 -OU3 <br />Electrical Contractor Mail Address City State/Zip Phone <br />250,w <br />��� 15 �W State License NumberContract Price of Work <br />y r K ED cAwlle <br />Proposed Use of Building Contact Person (Plan Review) <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) 1 <br />Description of Work to Be Done: l% (oeR Out tiMMMe Qen�rt Z a lCewU^>< rf to �'�'r" <br />1O k'KA vAN�A <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 o too <br />I hereby certify that I have read and examined this application and know the same to he true and JJJ <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 13o p , O /_ <br />performance of construction. That I am authorized by the owner of this property to perform the o 6O <br />work for which application Is made and I comply with the State Contractors Law 18.27 RCW and <br />296. 00 WAC <br />&1"14 <br />8 •13- 13 <br />Sig a Date <br />REVISED117aa13 <br />