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Jun 26 14 01:35p p.2 <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.org <br /> PROJECT ADDRESS <br /> t-D331z -L,R- ('. LC'_c_ 15, 'r4c1- (y f <br /> Owner Mail Address City StatelZio Phone <br /> Tenant Mail Address City Stater2ip Phone, <br /> c 1� ) �i �Vr'� LI� 1-t15 Lick 6-1-67)-S` (cf': <br /> Electrical Contractor Mail Address City StateiZip Phone <br /> .Di Sei. 4 Lam , <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> 1tG' <br /> Square Footage(if residential new construction, remodel or addition) <br /> Number of devices(If low voltage) <br /> Y \-141—Description of Work to Be Done: k r 1 -1 — <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that T have read and examined this application and know the same to he true and <br /> correct. Art provisions of Jaws 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 ` f� s <br /> performance of construction, That I am authorized by We owner of this property to perform the EI �1 17 <br /> work for which application is made and I empty with the Slate Contractors Law 18.27 ROW and <br /> 298.200 WAC. <br /> (z.V3 /19- <br /> netu re Date <br /> • <br /> P.tSEO.123/f3 �_� <br />