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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.gov <br /> 3003 fflo - 6 0,;i�. Ly x-fr, 4A 7 2U <br /> PROJECT ADDRESS <br /> 13)SA 300 3 AJ rS r ��.sk,o �� ��ao►�v�l' . �i�1 ?dLo 2 <br /> Owner Mail Address City State/Zip Phone <br /> Lam' K� r-g u t �` Cyz$")2 3 7-/t 0 8 <br /> 111'rm-: <br /> TFnant Mail Address Ci:y State2ip Phor:e <br /> SPc �"'�+T�ry�wtr�a So4trr� <br /> .�/y,c i4L f Oer rrdw L r b. 6301 &AmAmw ?P �.�wr PA . FL r-N ger - 7A pv <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> SPL Zt4T-S 7(o 23 r' <br /> State License Number(required) City of Everett Business License Number(required) <br /> ow Ilo�jAG�' f"at, /1�nuY' dsm4 7-- -VA411 <br /> Proposed Use o Building Contract Price of Work <br /> /J- /A Jeff co4ucc= (y2tZGY7-0$/9 <br /> Square F tage(If residential new construction, remodel or addition) Contact/Person/Contact Number/Email <br /> 2- 2- -Arff. CoGVCCX a AVXSK -C-0&n <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: --Lois-r ct. of&-cs /r"4N -C-4.;D AuPlby(S mc. SYs7rMs <br /> A",CC.uD4wc, V iDCO wAtt, � DISrcA.7S PSA-let fw- � s P4AX d�-S A.^j'a <br /> ASSor,i'0►-ro-z GABt-df- RuvS to Z Low VdLTAy�" . <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that 1 have read and examined this application and know the same to be true and 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 1 am authorized by the owner of this property to perform the E <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and �J <br /> 29620 C. <br /> '1'71 <br /> Signature Date <br /> REVISED 08/06/2014 <br />