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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.org <br /> 330L 1?-"' 5-� <br /> PROJECT ADDRESS <br /> L osc E e re.-�� I v a i 1 c r bt. OT <br /> Owner Mail Addre City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> 335-14 <br /> rizI- S+ E- 5v +4r wA 997-941 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> �131Gt-�o�Sgzy PN G -'`1198 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Pipe-k►r,e- Go ode Qb'�tc.-�-ie�n 4�025 . tO <br /> Proposed Use of Building Contract Price of Work 56"C.jun do <br /> Bill GCiS't 44D`-4018 -SoS3 4r*'%V'Er.0 rv\ <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: 1-�S�a 11 `ntw QmS'F n1O��}� l DO A �jCnv i Le <br /> Zv�S�io,11 Y�tw Z0 A 21404 Lircutjr +-a �ec-�•��@c- Ca6�he�' <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 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 l am authorized by the owner of this property to perform the t I (4 s <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Date <br /> REVISED 08/06/2014 <br />