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Oct. 24 2014 9: 38AV, No 7d99 P. 2 <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—wAy.everettwe.org <br /> rb- a4�fU <br /> CZ 14 /o-- fS6 <br /> SW ,eyetl, un>A �tsao3 <br /> PROJECTADDRESS <br /> I pn <br /> �1tf1G l4�Q ! t��ad+ ( I�l �Lo 5�'�LL� Fu �U.Fh9_t 3 uts7,0-� <br /> Owrr Ma.I Address City state/Zip Phone <br /> Tenant Mail Address City stalelzip Phone <br /> k1r, 14ti&ttr1o, the F, al n sh „fes ,ins uu•bM•'A4d <br /> Electrical Contractor Mae Address City statelzip phone <br /> hsHr GsKgt ye-- =X 019 Ldc-- <br /> State License Number(required) City of Everett Business License Number(teaulred) <br /> 9'3M.a O <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residenbal new construction.remodel or addition) Contact Persons enact Number/Email <br /> Number of devices(11 low voltage) <br /> Description of Work to Be Done P Gf b avLarn* — T OD CQ !. )�1111 n'00 <br /> 1prd9alnou�S -- -- <br /> FEE <br /> CITY OF EVERETT LOCAL SALCS TAX CODE IS 0105 <br /> I horoby certify that 1 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 bo completed <br /> whether specified horarn or not The granting of a permit does not presume to give authority to PERMfTB <br /> violate or cancel the provisions of any other state or local law regulating c o � �/ <br /> construction or the � n <br /> performance of consWctron That 1 am aufhonrod b the owner of this roe to peAorm the v � <br /> work for which application Is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 29ZA�p <br /> 10�ZN�I� <br /> ono ure <br /> aFvlt®06M901� <br />