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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 />PROJECT ADDRESS <br />&ra' tl M (,tin 51 a O - -33''d,4ue tJ E/e ✓Ct t 98'203 <br />Owner Mail Address City State/Zip,,,, _ 9 _, P Phone / <br />Tenant Mad Address City Slate/Zip Phone <br />ElecIncal Con or Mail Address City SlalelZip Phone <br />Nzs- y93-03E <br />State License Number (required) City of Everett Business License Number (required) <br />Proposed Use of Buitd,rtg Contract Price of Work <br />q85 Co(�,j 71L (je.r <br />Square Footage (If residential new construction, remodel or addition) C(Maact Person/Co ct Number/Email <br />AJIA <br />Num er of devices (If low volts <br />Description of Work to Be Done: 1'11-fC,�let� VernOcl��, oet,J �(UC)1(Cc.ilcps. <br />od hOL 1 DVU(rA1�Lf rr++ <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �J <br />I hereby certify that / have read and examined this application and know the sarno to be true and l <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 pemid 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 <br />work for which application /s made and 1 comply with the State Contractors Law 18.27 RCW and <br />296 200 A <br />�Kjgnalilire Date <br />REVISED 08t167014 — — <br />RIA <br />