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Ahk <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — W.vw.everettwa.org <br />0 <br />PROJECT ADDRESS <br />f <br />� h o r n �f() (� C r�� �I �iD� S�� �� llti ✓ wtir— 966 opt) <br />Owner Mal Address City SlatelZip Phone <br />f MA <br />Tenant Mail Address City State/Zip Phone <br />_ � �so tie-t I�latr M 1 533 (e�'` 5i S IG��r 1 �.o( 9�or� ��3 azs ►o <br />Electrical Conlrac or Mail Address City State/Zip Phone <br />W-2?�b Pa1D c2 9 (01 <br />State License Number Contract Price of Work <br />00r(- 6L)�'O— C� tht+1� i�n�s5 <br />Proposed Use of Building Contact Person (Plan Review) <br />Z,o I U-u7v <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) {, L <br />Description of Work to Be Done: <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 1901, <br />1 hereby certify that 1 have read and examined this application and know the same to be 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 r I O 'O , I <br />performance of construction. That I am authorized by the owner of this property to perform the t q <br />work for which application is made and I comply with the State Contractors Law 18,27 RCW and <br />296,200 WAC f <br />? // <br />Signature ate <br />REVISED 3120113 <br />