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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 />��r'j0�-17 � <br />3-5-15 <br />�� �P: �- 5'�� <br />PROJECT ADDRESS <br />Everett Hausing Authority 3107 Colby Ave Everett WA 98206 425-303-1121 <br />Owner Mad Address Ciry State2p Phone <br />Tenant <br />MadAddress <br />c�ry <br />StatNZip <br />Phone <br />West Coast Electrical Services 12527 Mukilteo Speedway #103 Lynnwood WA 98087 425-322-3189 <br />Electrical Coniractor Mail Address Ciry State2ip Phone <br />WESTCCE897PQ <br />State L�cense Number (required) <br />Duplex residential <br />Proposed Use oi Building <br />1150 <br />Square Footaqe (If residential new constmcilon, remodel or addiUon) <br />Number of devices (If low voltage) <br />oescr�pi�on or wo�k �o ee �one Remodel of existing duplex <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />053544 <br />City of Everett Business License Number (required) <br />$5,600 <br />Contract Pnce of Work <br />Kyle Adams 425-322-3189 <br />Contact PersonlContact NumbenEmail <br />1 hereby certdy thof 1 have read and examined this application and know the same to be true and <br />conect All provisions o/ laws and Ordinances goveming fhis type o/ work w�ll 6e completed <br />whether specdietl herein or no[ The granting o/ a permd does not presumc to give aufhonty !o <br />violate or cancel fhe provisions o/ any other stafe or local law regulafing construction or the <br />peAomiance ol conshuction. Thaf 1 am authonzed by fhe owner ol thls property to peAorm fbe <br />woik /or whicb application is made and I comply wdh fhe Stale Contractors Law 18 77 RCW and <br />296 200 W C. <br />�L/`'� �� 2/ZSll� <br />aeviseoaevsoo�a <br />FEE <br />d�� <br />� <br />PERMR� <br />E 15a2- �lh <br />