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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 /> 2530 Ma Ie 5 , iveret t WA 982OI <br /> PROJECT ADDRESS <br /> Ku;Ser Pe(Marrefl*`e 293 Mu�it 5�. ��t�rr� - VA q ZO). (z06J 3dz-! GIj <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City statelzip Phone <br /> i <br /> �r trie. 6�de-f- 13301 SL ?.6'" S"[ Be )je_ WA qOO6 42-;-"74-)-57&D <br /> Electrical Contractor Mail Address City Statemp - Phone <br /> Pk'_IMUII34 8r. 206 8 <br /> State License Number Contract Price of Work <br /> „}ooc.4han N le b�� ��knC,t✓ � y I'��try C6SSe'�'l-ex <br /> Propose Use of Building Contact Person (Plan Review) <br /> 737 <br /> x <br /> Square Footage(If residential new construction,remodel or addition) <br /> Z <br /> Number of devices(if low voltage) <br /> Description of Work to Be Done: Pr,d rd e e)ec -Acqyj0 Y ar►rf � � earl re�>�'o <br /> iv�s'fia// CXZ} RPh door r vaer e-1+ors'• ,job r+lumer% �j 1 q <br /> l e u e l 1: i70:ro. looCly un�1 S 11 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE!S.3105 <br /> I hereby certify that 1 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 herain or not The granting of permit does not presume to give authorityto PERMIT# <br /> violate or cancel the provisions of any other state oriocal law regulating constructlon or the <br /> performance of construction. That I am authorized by the owner of this property to perform the E <br /> work for which application is made and I comply with the State Contractors taw 18.27 RCW and <br /> 296.200 WAC, <br /> - <br /> 7-1 <br /> Signature <br /> Signature Date <br /> REVISED-Va'18 <br />