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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 /> 10,20D I q+V� AQe sE <br /> PROJECT ADDRESS <br /> C�S�c o �QQO 1`24 kye 8202 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Nor- west i v� to sf FL NS tJoedAjo;/(t• WA 48072. g25-B06- <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> �ORTi;AC1- 483R® 0506 qq <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work O1er§,ry xAison• CO W1 <br /> Dl Woe- <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: <br /> ocJl ,-� L �too S <br /> 160)gSL(Y)ar* <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 specified herein o not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancel the pro ions of any other state or local law regulating construction or the <br /> performance of constry0on. That/am authorized by the owner of this property to perform the E <br /> work for which 9ppli on is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC <br /> 45�l <br /> Signature Date <br /> REVISED 08/06/2014 <br />