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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org <br />jiq06 OAKP--r- AVq <br />PROJECT ADDRESS <br />�,�'Aitv'z OL,5od moc oaks,eNA N Q � (r) �y 0\' <br />Owner Mail Address City State/Zip Phone <br />N-)CK 4mso�j 1906 0(k��s c\\,K �VIPRI� UJI (N ?3c) — 3�05 <br />Tenant Mail Address City State/Zip Phone <br />ow ne-(- <br />Electrical Contractor Mail Address City State/Zip Phone <br />State License Number (required) City of Everett Business License Number (required) <br />A�n Ce <br />Proposed Use of Building Contract Price of Work <br />�Jick WOkKs;�)f� <br />Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br />Number 6f devices (If iow voltage) <br />Description of Work to Be Done: —o\ n!) (-I fs Lo 5; 1 N� Ki I-c- k e V) <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 5 0 C) <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 specffled 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 <br />performance of construction. That/ am authorized by the owner of this property to perform the EV6502-00J <br />work for which application is made and/ comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />a <br />Signature Date <br />REVISED 0810612014 <br />