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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 />lyoR �,�, Ct/to cH plat/ UA;e #3440 lfiy c i� lt/l9 58Z08 <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />�irk+naftr,.l R.j4tAnkel /yoZ �E F_vr.�HN*,I/r✓uy �Ey�r��Gul4 98z�� yX-3S?-177 <br />Tenant Mail Address city Stale/Zip Phone <br />Sou,+c/sRclatrod Servers l;.v7J'6aGs4Afe lZor'd F✓e.e# 1✓Hrjfzod ya7.3%5s" <br />Electrical Contractor Mad Address City State/Zip Phone <br />5CV1ic155 g'?6,T9 `1650 <br />Slane License Number Contract Price of Work <br />fez 16 1 <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) n 1 <br />Description of Work to Be Done. 4/i Ahnz— <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have mad 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 <br />performance of construction. That I am authorized by the owner of this property to perform the t ( 31 R _ <br />work for which application is made and 1 comply with the Stato Contractors Law 18. 27 RCW and <br />296.200 WAC. <br />Sig —nature Dale <br />REVrSED "Orj <br />