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ELECTRICAL, PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRFET, EVERETT, WA 98201 <br />425-257--8810 - FAX 425-257 8857 -- www.everettwei.oirg <br />d � ila 5,, S <br />PROJECT ADDRESS <br />EI LA.e't�C crh �L �rivr,Q��v� 13c,..Idl.�..� 14 1,57-0 �s'© f3 S_k _5 W elfl- LA A <br />Owner Mail Addr+eSS ` City Statualp Phone <br />r <br />Tenant Mail Address City State2ip Poona <br />Contractor <br />.CAS C_C, Ljo <br />State License Number (required) <br />P•::.pcseb Use of Building <br />Address <br />City 5g:A — Statemp L.S A,- Ptione <br />`3-7 . C) <br />City of Everett Business License Number (required) <br />20, u� <br />Contract Price of Work <br />1"1)4krr."Ak A.I L p CA' .rL., �r 0 <br />Square Footage (If residential new construction, remodel or addition) Contact P rsonlCantact Num a !Email <br />Number of devices (if low voltage) <br />Description of Work to Be Done: _ 3 0U .� <br />CITY OF EVERM LOCAL. SALES TAX CODE IS 8105 <br />I herby certify that I have mad 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 here n or not. The granting ofa permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is meda and I comply with the Stele Contractors Law 18.27 RCW and <br />296,200 WAC. <br />5 -j-%S <br />Signature oat— - _ _ <br />REVISEDGM62014 <br />FEE <br />PERM, T# <br />E k5 05- 003 _ <br />