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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 />S, SE- <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />ji:�" r� Fcvc�ebe <br />Mail Address <br />Mail Address <br />GI yol� /03 <br />b 5 So -'T <br />10?-3 SE - <br />COY <br />city <br />StatelZip <br />State/Zip <br />Phone <br />Phone <br />i�3 Weu C. Z°IZS Ila" PLSiL �.O W °IBEX �zS-E370 •6%1 <br />Electrical Contractor Mail Address city Stateitrp Phone <br />_ D3 LL&3?-9 !%N <br />Stale License Number <br />i?cs' o16,jlh <br />Proposed Use of Building <br />Square Footage (If residential new remodel or addition) <br />Number of devices (If low voltage) <br />25U)"� <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done A()o NeW (teLu`TS + j k 4 16,4 Jj t7' ) y kit <br />ALn J"(t tac Fecile (44TO^ 6%1h t t, ��25 re fx%. �-S Cv\d WuC 614 <br />_ vo c IRw,b . - --- - <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that 1 have read and examined this application and Anow the same to be true and <br />correct. All provisions of laws and ordinances govoming this type of work will be completed <br />whether sppcified horein or not. The granting of a permit does not presume to give authodly to <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 <br />work for which application is made and 1 comply with the State Contractors Law 18 27 RCW and <br />296 200 WAC , A <br />Tq,j ?J / `/ <br />FEE <br />PERMIT# <br />E No( I <br />REVISFa <br />