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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 />c- 1503 -N3 <br />BOZ gird 5� 3-as-is <br />PROJECT ADDRESS <br />_I, r- owes �OZ cj 3'� S�yeRc w� %02�8 Nzs s3o.124' <br />Owner Mail Address City State/Zip Phone <br />Tenant Mad Address City Statel7ip Phone <br />T-in�6)80, dl!&�4L (0N2sOjje 64kS6rM IAA 90266(Nib)Z35-o1013 <br />Electrical Contractor Mail Address City Stale/Zip Phone <br />Jn►kuv 6 95'zQ6 <br />Slate License Number (required) <br />Proposed Use of Building <br />SgLare Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done UH e <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />oqq -Ibb <br />City of Everett Business license Number (required) <br />1- /.M -" <br />Contract Price of Work <br />(.vC jots �` z4) Z311 -66-15' <br />Contact Perso iConlact Numb@dEma1l <br />I hereby certify that I have read and examined this application and know the same In be true and <br />correct All provisions of laws and ordinances govennng this type of work will be completed <br />whether specrrted hemin or not The granting of a permit does not presume to give authonly to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That 1 am authonaed by the owner of this property to perform the <br />work (of which application is mado and 1 comply with the State Contractors Law 18 27 RCW and <br />296 200 WAC <br />FEE �Y <br />�O w <br />PERMIT# <br />REVISEDO&lmmr1 <br />