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01/06/2015 09:31 3604740126 DONNELSON ELECTRIC INC #3293 P. 001 /001 <br /> • <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 /> --9-&0--- t O1ve 1/ r2 d <br /> PROJECT ADDRESS <br /> el <br /> 11C-ii-c-/ 13 ctrJ • . ?O aPis '2'135vlle 1.4o. 9y270 _ yZs-ex-gs--n <br /> Owner Mail Address City State/Zip Phone <br /> t � <br /> Tenant Mail Address City State/Zip Phone <br /> borne 15-4,--? e/eco,.c. 139 47 05," Ape 40;65112, iv>9- 5-kzz3 30,- 35_6-iz‘ <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> Oildlee o- qPZ <br /> State License Number(required) City of Everett Business License Number(required) <br /> ri?IV At.`2Cre 00 <br /> Proposed Use of Building • Contract Price of Work <br /> --e.97] ,%2;7.-- F&iterit. v '-1 Zs-Z3F `(7'/ <br /> • Square Footage(If residential new construction,remodel or addition) Contact Person/Contact Number/Email <br /> • <br /> Number of devices(lf low voltage) / <br /> Description of Work to Be Done: iVyv 1)0 -ec t.e <br /> • <br /> - 1 <br /> • <br /> FEE <br /> q 00 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 39 05 • <br /> I hereby certify that I have read and examined this application and know the same to be true and. C <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 provisio any other state or local law regulating construction or the <br /> performance of constr -hon. at I am , -. ' - . the owner of this property to perform the E 1501 .- 0E1 <br /> work for which al- ation .' ma.. : • I comp! , the State Contractors Law 18.27 RCW and <br /> 296.200 WA <br /> /i <br /> Signature Date -" <br /> REV/SP OS/06/2014 <br />