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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-v m.everettwa.org <br /> -- ---------------- ---------------- ------------------------ <br /> 7� <br /> PROJECT ADDRESS <br /> /0"k, P Gw'lnl� 'G y3 L/i LoN►vE� I.✓1� r1�z�7 yZ� .�5�-Y1G;3 <br /> Ow01,A-1V <br /> er Mail Address City State/Zip Phone <br /> L 0 P TL)w c M G— <br /> Tenant Mail Address City State/Zip Phone <br /> I <br /> LOAtAL LLELTA-V— -Ikbet Mt-13P..&KLL. Awk Eur ,&—ir- k/t 9iL^10 i 'i.1f.2fa-17P <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 0A9LE9-1 r�.IL,Q Q 0 2) -7 Q ILL <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> €3►.0 .S i hitt;w& 3 L-D -Os i i <br /> ds' e-t e.v,.id.,,..I.E -Iect*-is.E cV%. <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: L.C0 !G 147-5 To ///—I <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 4 <br /> I hereby cerflfy that 1 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/comply with the State Contractors Law 18.27 RCW and l C f <br /> 296.200 WAC. <br /> Signature Date <br /> REVISED 0610642014 <br />