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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 /> :. :444/7J-- -----3 ?----- j/k-12 4NIA- 0 <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip y_ phone <br /> FMCci j. C 4 Y'L /r 2)/c "``s ly Wdgar Give <br /> Tenant Mail Address City State/Zip Phone <br /> ,i f-_-Mvo Id /0 eat 1$`? £/ ftp/ VLF )c,9' 2/&/ <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> '72J fs/V LP 01 ( 3 4. 3 <br /> State License Number(required) City of Everett Business License Number(required) <br /> C 4g/(v-/y /;f40 " / fie — <br /> Proposed Use of Building Contract Price of Work <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: /2 C/A/C' /73 0&i !C c.}, (,�li 1%-g <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 k ©® <br /> 1 <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 �� rn <br /> performance of construction. That I am authorized by the owner of this property to perform the E <br /> work for which appli ation is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ign ure Date <br /> RE SED 08/06/2014 <br />