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0 <br />ELECTRICAL PERMIT APiPLdCA-Fd ON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257.8810 - FAX 425-257-8857 - www evereliwa org <br />2 I q q 2 "d Pit Sc , t:':�Vert-FA, VVA cyg Za e <br />PROJECT ADDRESS <br />Owner h1 dAddress Cdy <br />Tenant AV "id CIlep Mad Address <br />1ec,j r Fe 6,1, l 9 66 I z4" PL <br />Electrical Contractor Mail Address <br />A o'0JK.T q 0 L,T9 <br />Slate license Number <br />Irk (�l CAP N I�1Q�I <br />Proposed Use of Budding <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />City <br />%i rIC1A4A.j <br />City <br />N/A 9ezoy <br />SlatelZip Phone <br />r SlalelLp Phone <br />V✓A U031 yls-753-76S <br />Stafe)Z,p Phone <br />ilo, C) <br />Coalracl Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done _- - Ir-e CeI <br />A badL_------- <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 t j boo <br />I hereby certify that I have read and eirammed this application and know the some 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 lucal law regulating construction or the <br />performance of construction chat I am authorized by the owner of (his properly to perform the E- <br />work for which application made and I comply with the State Contractors Law 18.27 RCW and <br />296 200 WAC <br />