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• • <br /> 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 /> •3003 fest- C45-,A0 45,Ao RD L1'O -g ---5-4q <br /> PROJECT ADDRESS COI - SI <br /> N tAl cifriud) <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Prtne. EIec}r:c 13301 5z 2.0" Bellevue wf ggv5 2.12-c-741-57.at <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> PRI ll E I 134 T. 20,000 <br /> State License Number Contract rice of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> 25 K G.CC SPt <br /> Square Footage(If residential new construction, remodel or addition) <br /> Number of devices(If low voltage) /� <br /> Description of Work to Be Done: 1' 1c1rV"� Sq P D ego <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 .. <br /> , D <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 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 . I 1-1 _O <br /> performance of construction. That!am authorized by the owner of this property to perform the E yl C, <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> /,I ;« 3 <br /> , Signaie 'ate <br /> REVISED 32003 <br />