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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 /> 3 3® Z ( � 5-r <br /> PROJECT ADDRESS <br /> CL-�y a-� Evef�-4�r Park 9ap-t- �yece't'� wfl -T$ 2.01 - L101 $ <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Q tg�ar� �tc��c'ec®►1 Sevutce.S 335'0( I4Z��° 5$ SE So Iran WA 9$ 2.Q L( <br /> Electrical Contractor Mail Address City State/Zip 2OG,�4 Phone <br /> - gne <br /> -94� BIG140E5 Zk( Plel ®Sy 198 <br /> State License Number(required) City of Everett Business License Number(required) <br /> 3t 538 . 9 <br /> Proposed Use of Building Contract Price of Work <br /> Bill &e%:5* 2-0116 -49 S-BosB <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> 5�e-h,s�non��ec, ca <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: -�^-� t� t Od fa <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I 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 specifled 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 E C �d15—Oq N9 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Date <br /> REVISED 08/06/2014 <br />