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ELECTRICAL PERMIT ', PPLICATION <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 /> PROJECT ADDRESS <br /> foo <br /> 2-.14ALIKI-T;/2- z2c._ "04,--_,A, icg7 ,5,17,3 Ilxii 16/4 - ,5'29/ -_-3ccs- <br /> A6):13. - - 1 <br /> Owner Mail Address City State/Zip Phone <br /> /0 <br /> TenantMail Address City State/Zip Phone <br /> nt1 <br /> 16- <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(r�equired) City of Everett Business License Number(required) <br /> movl L;n � <br /> Proposed Use of Building 0 / 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 /> 4Description of Work to Be Done: Lti' [�- L' <br /> - �, l <br /> C cam'.A..41,3--efiL 61j- v4 a /e/.3-r/- ,ry..c., �,c) G2 r-c:v, J. g4ti^�� f� _J <br /> ^-e 44 0 Yl L VC-r' �'! 7C,4-7e:_f co. M cg--4 �e-d'/)z9i'0"..f , <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 7 09 <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 <br /> performance of construction. That I am authorized by the owner of this property to perform the E IA) (5( 0- ow <br /> w <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 . <br /> ire/22//f <br /> Signature Date <br /> ' <br /> REVISED 08/06/2014 <br />