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• <br />e <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, VVA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />(- `ate �+ <br />9c,a9 -L"; rQYeaIJ &)AV <br />PROJECT ADDRESS <br />APi; �p� 9(�9 )�;,p,AYeeN iFgaoI yz�-773-'1Q <br />Owner Mail Address Or City State/Zip Phone <br />Torfi'-�$ L-0 C Cic, <br />Tenant �-� Mail Address City State/Zip Phone <br />SPlfa c �1�� SPir ire �/�/lJ ear �hr RJ SrvAom sk 95790 raa3_ 7 - 00 <br />Electrical Contractor Mail Address City Slate/Zip Phone <br />20coclo <br />Slate License Number Contract Price of Work <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) <br />[ / <br />Descriplion of Work to Be Done: 6k ri ii P k (.rr i' C(A AllB4O.4, - — Add'I If Tee 0 iV <br />IS 3105 <br />FEE � O 2�jC7 <br />CITY OF EVERETT LOCAL SALES TAX CODE <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 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 />PERMIT# <br />violate or cancel the provisions of any others fate or local law regulating construction or the <br />of construction. That 1 am authorized by the ownerof this property to perform the <br />r <br />t r (v yh l <br />performance <br />work for which application is made and/ comply with the State Contractors Law 16.27 RCW and <br />296.200 WAC. <br />