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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 - anvw.everetbaa.org <br />Gmel -oob <br />-7- <br />PROJECT ADDRESS <br />�flr/ onrli L ��� <br />Owner Mail Address Gry Slate/Zip Phone <br />Tenant Mad Address City Slate/Zip Phone <br />/1911NE 4 LC GT.PiL ! ys Z / �d 32, S� S�„rr�/ ria111kW. GiJ/' jP2 � <br />Electrical Contractor hlad Address City �j State/Zip 7eU t;63 4G� <br />R, 6 % 6 7^ <br />Stale License Number Contract Price of Work <br />e-g <br />Proposed Use of Building <br />2, svv <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Contact Person (Plan Review) <br />gob .gSP6-ac) 9,0 <br />Description of Work to Be Done: y (g e-�'✓ �� -✓ <br />R&-allab f-Rw��- <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 A D - 0 S <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 permif does not presume to give authonty to PERM171t <br />violate or cancel the provisions of any other state or local law regulating construction or the r b bo <br />performance of construction. That I am authorized by the owner of this property to perform the t <br />work for which application is made and I comply with the Slate Contractors Law 18.27 RCW and <br />296 200 WA,'9 <br />