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Jul 24 2014 9:20AM HP Fax page 2 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERV#CES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 4.25-287-8810 - FAX 425-257-8857-www.evwettwa.org <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail AddressQty StatelZip ( Phone <br /> Z -C- A- 1 e- <br /> Electrical Contractor Mail Address !/ <br /> City St z Phone <br /> C�h�U� Ccs ' <br /> State License NumberContrast Price of Work <br /> Proposed tJ of Building Contact Person (Plan Review) <br /> Square Footage(It rest a tia new construction, remodel or addition) <br /> Number of devices(If IoW voltage) <br /> Description of Work to Be Done: /?i p r< -� �•�vG drC <br /> i <br /> FEE 00 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 Q` D <br /> 1 hereby certify that I have react and examined Ibis aprlicatlgn 8W know ttie same tv be true auxt (J� <br /> 00r�t, Alt pmvisions of lar. aw 0rCfiner>,�s gWet»it�7 UUuus b+t�cx+►mak t ba cut ptet$d <br /> vvhefher specified harelir or rte Tho g ran of a PG'*does not pmsuma to gives atttho " to <br /> vtlate or camel the provisions of an Y PERMIT# <br /> Y or tncef taw re�►ttla#In�g canstru or the <br /> luno of(*r?s&trcftn. That au oxYx by the o%rw of ti'►is pttodiy b i�'�Nie E � <br /> work For atlort i f th®State CC0+t tors law ia.27'RCWand <br /> 296.2ao AC. <br /> Si ure <br /> Date / <br /> REVISED 32413 <br />