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AM, Ah <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 /> Svi4 , lot <br /> PROJECT ADDRESS <br /> '1I <br /> ��iJDeRtJ�o`� �A2�lP.a� ?-Jeae <br /> Owner Mail Address City State/Zip Phone <br /> '3>s—� .i . (A-m <br /> Tenant Mail Address City State/Zip Phone <br /> awidu;5a�l�p �e. b•. �f/off F Pz NG✓ Akz1ow m <br /> Electrical Contractdr Mail Address City State/Zip Phone <br /> State License Number(re uir6d)(' City of Everett Business License Number(required) <br /> C-0 I --(LLiN. iL6 ZI1SS <br /> Proposed Use of Building C'o'ntract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number Em '1 <br /> 1 <br /> CZ k ..s�-SYS <br /> N ber of devices(If low voltage) <br /> Description of Work to Be Done: <br /> .�(J�8t21M.OS TA� A N� COw1� 01 W IRIN <br /> FEE <br /> `S <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 ^ <br /> performance of construction. That I am authorized by the owner of this property to perform the t L <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Date <br /> REVISED OM612014 <br />