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�r <br />ELECTRICAL PERMIT APPL��ATION <br />CITI( OF EVER�TT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org � <br />3�5—l5 <br />��sb�-�� <br />�Z � `, „�z � S-� <br />PROJECT ADDRESS <br />Everett Housing Authority 3107 Colby Ave <br />Owner <br />Tenant <br />Mail �ddmss <br />Mail l�dtlmss <br />Everett <br />c�ry <br />C�ry <br />West Coast Electrical Services 12527 Mukilteo S <br />Elec�rical Conlractor Mad �ddmss <br />WESTCCE897PQ <br />State Ucense Number (reqwred) <br />Duplex residential <br />'roposed Use of Bmlding <br />1150 <br />Square Footage (I( residential new construction, remodel or adddion) <br />Number of devices (If low voltage) <br />Iway #10? Lyn <br />City <br />053544 <br />Description of Work to Be Done Remadel of existing duplex <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />WA 98206 425-303-1121 <br />SlatclZip <br />Slate/Zip <br />Phone <br />PhonC <br />nwood WA 98087 425-322-3189 <br />Slate/dp <br />P�onc <br />Ciry of Everetl Business License Number (required) <br />$5,600 <br />Contract Pr�ce of Work <br />Kyle Adams 425-322-3189 <br />Contact PersonlContact NumbedEmail <br />1 hereUy certJy fhal I have read ond exammr.d7his opplicahon and know (he same fo be Uue and <br />r,onect All prov�sions o! laws and orUmances goveming fhis fype ol work wdl be r.nmple(ed <br />�vhefher specdied heroin ar nol 7he granhng ol a pr,rmd does not presume to yrve �ulhonty lo <br />violafe o� cancel fhe prnvisiors ol ��ny other sfafr, orlor.al law regulal�ng r.anslruclron or Ihe <br />peAormance ol conslruc6on Thaf 1 am �ulhonzed by fhe owner ol fhrs p�operiy fo perlo�m (he <br />�:�ork loi whlch appl�calwn is made and I r.omply wdh fhe Stale Contraclors Law 18 27 RCI�' and <br />296 200 WAC. / <br />�!� -��/��-� z (zSJ r � <br />FEE <br />g�o� <br />PERMIT# I�S � <br />�i <br />E150z - ' <br />