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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 /> L/(00 q1LI/VE <br /> PROJECT ADDRESS <br /> Pecker • W ex s (--AAvc g vv r ± jA qt s‘Z0. <br /> Owner Mail Address City State/Zip Phone <br /> / / / / <br /> Tenant Mail Address City State/Zip Phone <br /> ./—%C_C,cIA,\101•SL kL-r-ii<( 1 f 1-14 U;sla nr, ,_sk 1a ( 2.90 *)S763-6.51/ <br /> Electrical Contrbctor Mail Address City State/Zip Phone <br /> • <br /> State License Number(required) City of Everett Business License Number(required) <br /> 0 <br /> i <;,.d tirgi 1 ACU i 4-kV/A I Del/,,z� UnI.- '-‘115-/.5 `� <br /> Proposed Use of Building J Contract Price of Work <br /> 00 .)r,1.L V6,365"./ bicat9Accn. .'/,F1cc+ric.CoY.., <br /> Square Footage(If residential new construction, remodel or addition) Contact Person Contact Num er/Email <br /> Number of devices(If low voltage) / <br /> Description of Work to Be Done: �ii11'rC' A D( 1q / Zinc Ate (--ixtc`ij /lC'�r b.Rc <br /> 111 1,1/A-(,i6V I Glr61i1/UAd VLM <br /> • <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 115 C/� <br /> I hereby certify that l 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 \'6-1 D ^ <br /> performance of construction. That I am authorized by the owner of this property to perform theE — L <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> _ /� 2 20/s <br /> Signa ure Date <br /> REVISED 08/06/2014 <br />