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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 />2�(0 0 klut <br />PROJECT ADDRESS <br />Vt <br />Owner Mail Address City State/Zip Phone <br />4 <br />Tenait Mail Address City State/Zip Phone <br />P..K;;V,,, t,L6 ►A(q% 56&'10� 74 Wks W-4 Rib Z�63dY <br />Electrical Contractor Mad Address City State/Zip Phone <br />i� <br />iPAIA� V4fs—lt-� applir6Q f� z��ls <br />Slate License Number (required) City of Everett Business Ucens& Number (required) <br />residentia l 4'W 0 <br />Proposed Use of Building Contract Price of Work <br />Lc em f 6 14& 384 0861 <br />Square Footage (If residential new cc—struction, remodel or addition) Contact Person/Conlacl Number/Email <br />Number of devices (If low voltage) I 1� e <br />Description of Work to Be Done: ?A yW, ( t� JQC,60r /K V" <br />FEE , �1 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 75 V / <br />I hereby certify that I have read and examined this application and know the same to be true and <br />:orrect. All provisions of laws and ordinances governing this type of work will be completed <br />vhether specified herein or not. The granting ofa 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 1 am authorized by the owner of this property to perform the 12 <br />work forPT77 <br />'h the State Contractors Law 18.27 RCW and <br />296.200 Date <br />PEWSE00a 014 _ <br />