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07121/2014 17:00 206957Fj ff BLUE SKY ITI PAGE 02/02 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98204 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> 6U.. 6�91uol <br /> PROJECT ADDRESS 0 <br /> ; 0OC 37D 7 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mall Address City state/Zip Phon <br /> 62-0 <br /> A14. ffl6 05276-/00 <br /> Electrical Contractor Mail Address City T state/Zip Phone <br /> ,1- 23 --.� /Z S -:!� ` <br /> 04(4e-ss "" �LM <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residentlal new construction,remodel or addition) <br /> Number of devices(if low voltage) <br /> Description of Work to Be Done: <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that l have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances goveming this type of work will be completed <br /> whether specif7ed 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 4-3C _ <br /> performance of construction. That I am authorized by the owner of this property to p®rfonn the E <br /> workZ;7 <br /> whicho and I comply with the Stats Contractors Law 15.27 RCW and <br /> 296. <br /> Date <br /> REVISED 3120/73 <br />