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Jun 021408:29a p.1 <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 —www.everettwa.arg <br /> 14 15 H- n <br /> PROJECT ADDRESS <br /> X11\ e-c 6:;,(\ \I--u fi; � :3la10 vu_.\ q '%f LJ 7 <br /> Owner Mall Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> E l e'(Aril C' : `-4 - ! Ave,3C; tVilS d' (v p <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> RUF)`-r.71- i ,V DC <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <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: Cuser h en <br /> cl. e gyy <br /> JFEE vC, <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 /) <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing 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 1 am authorized by the owner of this property to perform the E it-10/04( 3 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RC W and <br /> 296.200 WAC. <br /> / :)-- I) <br /> - •nature Date <br /> REVISED 3/20(13 <br />