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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.everetLwa.org <br />PAL <br />G lSo 3—D 67 <br />PROJECT ADDRESS <br />\'��Y-&,o -Fre&ao =� NK MoA lij)Uk i,� <br />Owner Mail Address City State/Zip / )ZS 3 Phon <br />`I y-1i�93 <br />Wkipped Espresso Wr <br />Tenant I I I Mail Address City State/Zip Phone <br />oWn6f <br />Electrical Contractor Mail Address City Staletzip Phone <br />I001 Z112 c,2'7 <br />Slate License Number (required) City of Everett Business License Number (required) <br />Prop a of Building J Contract Price of Work <br />go =<� -�+. <br />Square Footage if residential new construction, remodel or addition) Contact Person/Contact Number/Email <br />Number of devices (If low voltage) p <br />Description of Work to Be Done: <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 Do <br />I hereby certify that I have read and examined this application and know Ilia 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 f construction. That 1 authorized by the owner of this property to perform the E 15 0 3 — f,k(J� <br />work for is application is mad nd 1 comply with the State Contractors Law 18.27 RCW and v <br />296.2 W C. <br />3-13- IS <br />S.g - Date <br />tZ <br />REVISEDO&W7014 <br />