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JUL/24/2015/FRI 02: 19 PM FPI Seattle FAX No, 42529p0 P. 001/001 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425257.-8810 - FAX 425-257-8857---www.everettwa.org <br /> ( f7 it Yr (Wt' <br /> PROJECT ADDRESS <br /> Un 4-end_ E-10r rt ei u ► ,.TN! - -5301 5. ` ,4-ei c ewoett;- �q aO3 _2,75r7 <br /> Owner Mail Address City State/Zip Phone <br /> .- Aa ? 024_er S:2_12.1 /-10j f iq e •1 6 -4-ea- !_.[� _W?o/ li '1, '7 V71 <br /> Tenant Mail Address City , State/Zip Phone <br /> eti- <br /> `t• n C>y .�vtr . • ,S 61I• . __Ain °•f, . • , - , r `*S.�.1,,r- — °0~ 96oZI <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> _Flee P.t* () 1 M r 1g <br /> State License Number(required) City of Everett Business sense Number(required) <br /> ( C) r► bad o iia-0, <br /> Proposed Use of Building Contract Price of Work <br /> iJjjA-AN ly{ D of -4a506.10 .9 tactSquare Footage residential new construction, remodel or addition) Contact Persot)/Contact Number/Email <br /> Number of dei/iee flow voltage) <br /> Description of Work to Be Done: /re 1 -- .ter / 4� P, ( e1"1 <br /> I'.• • – — .r ;.'1 # . ' s 0 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE JS 3105ft) 1 ' 5-0 <br /> I hereby certify that t 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 focal law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the E I.b 61 - l 0 <br /> work for which application is made and I comply with the State Contractors Law 15.27 RCW and <br /> 296.200 WAC_ <br /> 4011 • - - i194 /5 <br /> ignati e 'Date <br /> REVISED 081062014 <br />