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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 /> lD (/ I—l2 V—fes'/r// /` / C� i� /C <br /> PROJECT ADDRESS <br /> 7` aG LLC <br /> Owner Mail Address City State/Zip Phone <br /> / -o <br /> Tenant G Mail Address City State/Zip Phone <br /> S-UZZ 3 S �c ; lit/. Ly�,�.�,., tQ L( /1� 9,I)d 7 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> "f25'-- 7,�3 ^ 7G;;` <br /> State License Number Contract Price of Work <br /> &/'1/1 - <br /> Propose se of Building Contact Person (Plan Review) <br /> Square Footage (If residential new construction, remodel or addition) <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: `q U i.^-C <br /> /�vUC of W T V- C-/ -- C6'f <br /> c S tv-v v�.. l vZ il/ <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 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 n/ <br /> performance of construction. That l am authorized by the owner of this property to perform the �v I <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> j <br /> gnature Date <br /> %-=,',SZ=D 3120'13 <br /> f X111 <br />