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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 /> i/g 333 /f7": CSf (5v/,r /4/ <br /> PROJECT ADDRESS <br /> (5/2Pr/t /h'/tr Xrar,C LC C <br /> Owner K-Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> // /f/Art' 6-.��-cTi?,'(',/c c /?vi P./s Zet,ded514 ‘,;/''-iyA 9 c1,26'-77d' WWi <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> / <br /> �tlFiiirt:5 c9'1(2 -75 0 L ) <br /> State License Number(required) City of Everett Business License Number(required) <br /> Xi,go <br /> Proposed Use of Building Contract Price of Work <br /> LTf,/Sc /(a<3 gi//tra <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) / <br /> Description of Work to Be Done: ai?J x146/ //j S P,A t �/ ©(%'/�.e 15 OWI 7:549e%/'D!/1 r a <br /> /di e/( ('i 41/5 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 iv I 6- <br /> I y <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 ^ i I <br /> performance of construction. That I am authorized by the owner of this property to perform the E ,J q <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Date <br /> ,_...4//// t .,-s/1/n,, ,.9._ <br /> REVISED 08/06/2014 <br />