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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 /> 61 O\ A-ve <br /> PROJECT ADDRESS <br /> 51/4htVQ + 04\k '1 Q i i-)t'y4 A " ���f� � �� qz5-299 - 09 * <br /> Owner - Mail p Mail,Address City State/Zip Phone Fvw kr3 r taut‘ iovur) <br /> -i ..erviA-1- (h'nic <br /> Tenant Mail Address City State/Zip Phone <br /> S-i rtAtAi rLc1 Cl>►wAmtNI(yAivv►s 'Pp 7,ok I3to5 Sexoh.ov{nis14/ 0162e1I 425--3z4 S3'/3 <br /> Electrical Contractor Mail Address City // State/Zip Phone <br /> S 7-12. 00tr%)5(P <br /> State License Number(required) City of Everett Business License Number(required) <br /> +-44.4,-, -it- C I tv«c <br /> Proposed Use of Building Contract Price of Work <br /> 1)(A-i tv. \7vJa I ins--583-eigs Cp <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email tO� <br /> 300 <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: -FDIAAAALX S Cy vVi-Yo-1 I tt, P-CC4. 7V‘t f-vx o3' edc - `r-4104,41V r\ <br /> of 0494 Voice/4+a rabl,' � Cwf Cat/ r.00111,6) ilpM( c , k&zc , <br /> C DIM ‘A.v‘i CA -i o V C l os-e-+ r C C-` G�v�v�-✓� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 16500 <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 ^ _ O j <br /> performance of construction. That I am authorized by the owner of this property to perform the E `jl' <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 0/1-/20 1 <br /> re Date <br /> REVISED 08/06/2014 <br />