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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.evereftwa.org <br /> Vef fe-erg wad' <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> _K C'A oAon4-ics `)L-l0 y e vetitte n Gtbt-� rims- � WA 9 �10 3 <br /> Tenant Mail Address City State/Zip Phone <br /> P©S til TE 1Z �1rGTl2LCF�itc. 13S-Y, Rccrolt; Rb ROy✓ WA 79-a3 a ?40- 751-/300 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> Po--ry- SYS' 1) 4C 421767 <br /> State License Number(required) City of Everett Business License Number(required) <br /> �L-515 4 <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact' =mail <br /> Number of devices(If low voltage) <br /> z. ( <br /> Description of Work to Be Done: ��t•�d h <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions oflaws 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 l amuthor' d by the owner of this property to perform the t <br /> work for which"ication is m an comply with the State Contractors Law 18.27 RCW and <br /> 296>�WAj2! <br /> Signature to <br /> REVISED 08/06/2014 <br />