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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 />y�19 Nokr Air <br />PROJECT ADDRESS <br />jO &0triS 57(0lC11 NovT- 1344 Zug&zlvn �yZtj76o Z33I <br />Owner Mail Address City Slale0p Phone <br />Tenant Mail Address City Stale/Zip Phone <br />r'or»a/r &af/n 1�� Pv+3 52S G v�uu� Gu;'- 91n2zycLW-0373 <br />Electrical Contractor Mail Address City State/Zip Phone <br />Co r7 4if.r y7r/N`1 05-96 70 <br />State License Number (required) City of Everett Business License Number (required) <br />OILiLS DOeCN C-4 _ 0/ 900 . oa <br />Proposed Use of Building Contract Price of Work <br />Awe)Y Z/ S . Ila THI4Vlit <br />Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br />Number of devices (If low voltage) <br />Description of Work to Be Done � � rwL O F <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CLDE IS 3105 C5 <br />1 hereby certify that I have read and examined this application and know the same to be (rue and b <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herem or not. The granting of a permit does not presume to give authonly 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 <br />work for which ipp/ication is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Signature—� Date <br />REvrseooWW014 <br />