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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-vvvvw.e-vereftwa',org <br /> 021 L I t4DEA ST- E4fR-= WA-98 2.01 <br /> PROJECT ADDRESS <br /> C-1 01AU R- A" <br /> Owner Mall Address G4 Siatemp Phone <br /> Tenant Mall Address Ckty State/Zip Phone <br /> 4Z5-7*--re 11-9 <br /> Electrical Contractor Mail Address ofty State/Zip Phone <br /> O2-6Z4413* <br /> State License Number(required) City of Everett BLAsIneus License Number(required) <br /> Proposed Use of 8011ding Contract Price of Work <br /> MM4A4 WAj:j VAAJ '425-Z1,8- 1*71Y4 <br /> Square Footage(If residential new construction,remodel or addition) Contact Person/Contact NuMber/Emall <br /> NumbeOde ices(If low voltage) <br /> /A <br /> MVe- jztAjTAC'f4 1 -16 T- FIXT <br /> Description of Work to Be Done: VE <br /> —------------ <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby'cetffy that/have read and examined this application and know the same to be true and <br /> Correct All provisions of laws and ordinances govem[ng this type of work will be completed <br /> whether speciffed heroin or not 7ba granting of a permit,does not presume to give authority to PERMIT# <br /> violate or car)cel the provisions of any other state orlocal law regulating construction or the <br /> performance of-constructlon. That am authorized ply the owharof this property to perform the <br /> work for which application Is made and/comply with the State Contractors Eaw 18.27 RCW and <br /> 296.200 WA-C, <br /> Slonature <br /> REVISED OMIJ/20 14 <br />