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ELECTM'AL PERNT APPUCA TOM <br /> =Y OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> (obi <br /> PROJECT ADDRESS <br /> n( <br /> LS��OtvoSotn 2—re, -� �pe✓ � -5bo Sly r�/�al(GJ(ti/ �t 2og q�Z <br /> Owner Mail Address City State/Zip Phone <br /> qZ'5 ` 1 <br /> Tenant Mail Addr ss City State/Zip Phone <br /> t"—' (3300 5W563 ��B�LZ(P M�uc.-a�IC�,cl6!- OIZ <br /> Electrical Contractor Mail Address city StateOp <br /> State License Number(required) City of Everett Business License Number(required) <br /> a'&Zv'SC,�mt 'JF 'jDD'e.0 <br /> Proposed Use of Building Contract Price of Work <br /> l�out� �Vl((CEc�lOodS �FL�' 3S�i'1�1 OZ. <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: C k�WIT l Li P l �I�tn <br /> ZDo C "Yct4 woak It'ysc- 'l <br /> FEE I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I 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 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 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Date <br /> REVISED 06106/2014 <br />