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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-881 D - FAX 425-257-8857—www.everettwa.org <br /> 13 0 2 SE Ever c4 - y^'aj 4�aj <br /> PROJECT ADDRESS <br /> Eyrre4 NA/Sevuls <br /> Owner Mail Address City State/Zip Phone <br /> SACS <br /> Tenant Mail Address City State/Zip Phone <br /> Pritye aecte-c 13301 SE uTi ST Belkylje WA 9WC)5 42-;-141-520a <br /> Electrical Contractor Mail Address City State2ip PhoneA <br /> PP'IPjEE11S4 �r. t 7S- D vv <br /> State License Number Contract Price of Work <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) <br /> Description of Work to Be Done: A) rYlq ` 1 <br /> 1 ola t 16 3 8�� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that/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 /> whetherspecirred 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 ^I���J � <br /> performance of construction. Thatl am authorized by the owner of this property to perform the t <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> (2 -2 <br /> Signature Date <br /> REVISED 320/13 <br />