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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 /> 9'12.8 l it ,t) Li-)Ailura-`//7/O <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> V coui\-7( <br /> Tenant Mail Address City State/Zip Phone <br /> J- 3I '/ CL.tcr / 1 sza 7 2.ou itv6- 67/14 oic.2,0 14,4- ?4'0 a 'z 71?..e7 t <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> rill-LI g_e <br /> o .310 <br /> State License Number(required) 1 City of Everett Business License Number(required) <br /> [D00 , 00 <br /> Proposed Use of Building Contract Price of Work <br /> •0113 <br /> /IPKt-4dpyijj F5x.56Arrr ( 4L,G0d41 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: al-1 ,i f} UP lax 8174417 ?E -C- 1 e7'. ,Mg)E , 5€/4-7t4 <br /> �/x i 21E .5o APO/2,7 ,6011.0/00„. G it G- 640E, 7 c /140,w, bo <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 Cj(° <br /> I hereby certify that/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 1 ,n / O -�� <br /> performance of construction. That 1 am authorized by the owner of this property to perform the E �J� <br /> work for which application is made and 1 co ply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 717 — 4 r <br /> Signature Zf3 <br /> REVISED 08/062014 <br />