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To: Page 3 of 3 2015-05-26 18:58:31 (GMT) Fronn: Tyson O'Neill <br /> oyl <br /> 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 /> t. <br /> PROJECT ADDRESS <br /> ira f4swa.n. Y�, <br /> Owner Mail Address <br /> statelzip phone <br /> Tenant <br /> Mail Address City State/Zip Phone <br /> 6ul� qg2�3 3. <br /> 7-� <br /> C-hV C, /L <br /> 961 <br /> ElectriAl Contractor Mail Address City State/Zip Phone <br /> 05 11 Ap <br /> W State Ljg%nse Number(required) <br /> City of Evereft Business License Number(required) <br /> C <br /> Proposed Use of'Building Contract Price of Work <br /> q2*S <br /> �iquar6 Footage(if residenfial new construction,remodel or additio.n: <br /> Contact PersonlContact NumberlEmail <br /> Number of devices(if low voltage) <br /> Description of Work to Be Done: s4k)iv-, meJal lj t <br /> .d <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify`hat I have read and examined this application and know the sameb 0 e e <br /> I true and <br /> c0rmct, All Pfovisionsotla <br /> wsan0ordinancesgovaming this type of work will be colripleted <br /> d PERMIT# <br /> whether specifie0herein or not. Tire granting of apermit does not to give authority <br /> violate or cancel the provisions of any other state or locaf!aw regLilating.construction or the <br /> perfmmanceofconstruction. That i am authorized by the,owner of this property to perform the E <br /> work for which 8PP11catbn is made and I comply with the state Contractors Law 16.27 Raj')d <br /> 296,200 iN <br /> S <br /> ignitu nitu <br /> REVISED 081W,014 <br />