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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 /> god 7 EyeffYl all Uj a� <br /> PROJECT ADDRESS <br /> Owner Mail Address City At�(P State/Zip Phone <br /> CVeretf- IobC�Cfa Co. &G7 L,VZf,?+l Mall Lja� f\eye4 \AJA q$ _ <br /> Tenant Mail Address City State/Zip V Phone <br /> MET 51,g05 kPgU &Mt)e))-CVeA--4- Nom, Mil) CreeK. IVq 90019 4.25. 330.91160 <br /> Electrical Con ctor Mail Address City State/Zip Phone <br /> 3t3T51 SX g9CPQ '0 (F,5- av <br /> State License Number Contract Price of Work <br /> Co'✓+'1e,rc iG.l , e-A t S+7 0Z F-ra>)!,� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> Number of devices(If low voltage) 1\_ <br /> Description of Work to Be Done: 1 n : MQ l I LED ebi Cy) �.�Sp al -A W)' , <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 j�o �� <br /> 1 hereby certify that I have read and examined this application and know the same to be true and �1 ''J <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 local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the �V/(�► <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> _� ) 8 Lo <br /> ignature Date <br /> REVISED 3120113 <br />