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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 />5 <br />PROJECT ADDRESS <br />-4.�8-- <br />Owner Mail Address City Slate2ip Phone <br />.SJo - rst.lVj �j D � OV It 6-gA i l}Urz <br />Tenant Mail Address City State/Zip Phone <br />DA"L tELTIQIL 34ori r lLUJLLNLL A✓f Euc,¢cv lick 992ol hjr-1rJ-1700 <br />Electrical Contractor triad Address City Srlteizp Phone <br />OANLLEI `11LQD O to IL{ <br />State License Number (required) City of Everett Business License Number (required) <br />i6dd r= <br />Proposed Use of Building Contract Price of Work <br />61%w STr.UFkS alU-&41-OTII <br />ds�ei.ehs(�d�l.l�leetr�c.taw� <br />Square Footage (If residential new construction, remodel or addition) Contact PersonlContact NumbedEmad <br />Number of devices (If low voltage) <br />Descnption of Work to Be DoneA16 r ALL C r2C ci IT F0w- F,. <br />401A,7I K) MAP_ GNcck-okr <br />FEE /1 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 DSv <br />I hereby certify that l have read and examined this application and know the same lobe true and <br />correct. All provisions of laws and ordinances goveming 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 or this property to perform the t <br />work for which application is made and I comply with the Slate Contractors Law 1827 RCW and <br />296 200 WAC. <br />, Z &L= 7,�? ? , / s <br />Sig re Date <br />REVISED 060SW I. <br />