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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 /> / cQ 757' T L✓ <br /> PROJECT ADDRESS <br /> fiLl,t Cie P PD i') 'dc//;) f0;-- , Tt h/'�� g00_3 17'-25_3'i7-6la <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Dri44 L E.LEC T&[L. 240q f O PIII-4LL. Av E h01- c`d 10 i I/..7 S-a -171)ti <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> Dikt-ELLEi cAILQ8 U J G 614 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> intkk S'r t,ihlS 3LIb -L([-©Si t <br /> als$tvLvt4 .0 AA <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> • <br /> Description of Work to Be Done: ' (' VeL 1 1.- 1.>ba l D Nit/ i N J N C%IO14 <br /> Mi:(61),1 M 44: ty ►NI-E, <br /> FEE ,� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 k n/,21, �`� <br /> I hereby certify that I have read and examined this application and know the same to be true and `� v <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 theE J <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 <br /> Signature Date <br /> REVISED 08/062014 <br />