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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 425-257-8657 — www.everettwa.org <br />c � Sp;�-18� <br />��S ��u.`S�C s�C. <br />PROJECT ADDRESS <br />Everett Housing Authority 3107 Colby Ave <br />OwnOf Mail Atltlress <br />Tenant <br />Mail Address <br />Everett <br />Ciry <br />ciry <br />=�� _5-/ S <br />WA 98206 425-303-1121 <br />StalelZip <br />State/Zip <br />Phone <br />Phone <br />West Coast Electrical Services 12527 Mukilteo Speedway #103 Lynnwood WA 98087 425-322-3189 <br />Elecirical Coniractor Mail Address City StatelZp Phone <br />WESTCCE897PQ <br />State Llcense Number (required) <br />Dupiex residential <br />Proposed Use of Building <br />1150 <br />Square Footage pf residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />oescription orwork to ee oone: Remodel of existing duplex <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />053544 <br />Ciry of Everett Business License Number (required) <br />$$,6�0 <br />Contrect Pnce of Work <br />Kyle Adams 425-322-3189 <br />Contact PersonlContact NumbedEmail <br />1 hereby certily that I have read and examined this application and know fhe same to be true and <br />correct. All provisions o/ laws and ordinances governing fhis type o/ work will be comp/eted <br />whefher speci(ed herein or not. The granting oI a permit does not presume to give aulhoriry to <br />violate or cancel the provisions o/ any other state or local law regulating consfruction or the <br />peAormance o( consfruction. That I am aufhonzed by the owner of this property fo peAorm the <br />work lor which applicafion is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296200 WA <br />% /���— Z /z S �( � <br />FEVISED ofl�06?Oi< <br />FEE <br />�D p0 <br />PERMIT# <br />E I�o2- lg Z <br />