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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 — mmeverettwa.org <br />El4o6-�� <br />'"1t620 I <br />PROJECT ADDRESS <br />La'Sofl 15�3 I/'�qt'� A✓�- 1 ����ti� wl} gs120 I Z06-cilS-; <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City Slate/Zip Phone <br />(3n Si� �cof�� L(—C. grsZS 3Hri4✓� I�k �ifCL3c63 � fllr, 912SZ71 oral W25-SM-7 <br />Electrical Contractor Mail Address City State/Zip Phone <br />UTk SSE 9�r0PQ <br />Stale License Number <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />re__ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Cohtract Price of Work <br />Contact Person (Plan Review) <br />*cc _ r �r mot, n ✓cam %f o ) . <br />I hereby certify that I have read and examined this application and know the same to be true anti <br />correct. All provisions of laws and ordinances governing this typo of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give aulhonty to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. T 14'nin authorized by the owner of this property to perform the <br />work irr -which appliceti ' made and I comply with the State Contractors Law 10.27 RCW and <br />296.200 WAC. <br />FEE <br />75 CIO <br />PERMfTB <br />Elyo�-d58 <br />Dale <br />