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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 /> I 10 75i 5� 5 ) <br /> PROJECT ADDRESS <br /> FLIAKE Como, G" .2D 5o4,,my Lv6errr `6x33 <br /> Owner Mail Address City State/Zip Phone <br /> 50,4,E <br /> Tenant Mail Address City State/Zip Phone <br /> s Jykvi L e_LE.L i4.134 PLO Haat-ALL Avg E uz,&Tr 1.141-- C a0[ 1/J1-a c.)- <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> Ofti4LIEEI WJE.f21 tD T5 -1 614 <br /> State License Number(required) City of Everett Business License Number(required) <br /> 1� Dv°4 <br /> Proposed Use of Building Contract Price of Work <br /> 6004 SIVA/Chi& 2L.D -L.1! -Ds1 <br /> dskeve.ws axial.,zlcch-ice.tr.:v. <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: Ppt✓c►'Q. TV / 82. /401-60 Mxt,1-1 ftii( <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 g <br /> b ----- <br /> /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 0--0/5 <br /> performance of construction. That I am authorized by the owner of this property to perform the E <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Date <br /> REVISED 08/06/2014 <br />