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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 />T1na Rese <ve off- Eve Z* <br />$x�2o Eve11'5CZI vl <br />ENmst- t W A q�5 Zo�1 <br />PROJECT ADDRESS <br />R%SL.CVe C* CVCra 11' <br />TOAMTS, LLL-V 342LI Vio-Yor}o Sk& TO( Nawpor�-BU."I, <br />Owner <br />Mail Address <br />city <br />CA /gzG63 <br />Stale/Zip Phone <br />The i C5-er/ <br />Tenant Mail Address City Stale/Zip Phone <br />Express E,I¢Ctrcc 4o 8of13o85'l BellingHam WA 182 S-%0-671.0113 <br />Electrical Contractor Mail Address City State/Zip Phone <br />EXPREEI065DI <br />State License Number <br />A .r-t-fvv'A* gu:XC1125 <br />Proposed Use of Building <br />ly8 oy9 Sg F-r< <br />Square Footage (If residentl6l new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />New SCrviGa <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />� I,ILI'lf-S0.00 <br />Contract Price of Work <br />a2/Rnl /ryifcC.C/Z. <br />Contact Pe,son (Plan Review) <br />exPA4-55 Ebb G-/2r C- <br />eleetr,*c.d wieirtz <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 <br />violate or cancel the provisions of 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 1 comply with lire State Contractors Law 18.27 RCW and <br />296.200 WAC. / <br />TVIPHI-Vafa LXVjA <br />FEE <br />10, 59I l Z <br />PERMIT# <br />E q 0 2-0 -72 <br />aEWSEe.W0/13 <br />