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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 /> 37110 ‘APL-4 N AvE, EV meTr lAM "g#2.03 <br /> PROJECT ADDRESS <br /> JEssE J. JOE-- 3.71(, l ,P L& AVE,; e-y Tr (9A M-05 <br /> Owner Mail Address City State/Zip Phone <br /> ZvG- <br /> 4,157-76-80 <br /> Tenant Mail Address City State/Zip Phone <br /> owh-er <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> Si w&r- ;AM,6 t.. 12-m <br /> Proposed Use of Building Contract Price of Work <br /> 2712-r- ..t✓G�LQ <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: MNreki Re-04A 1+14-4-e— '' A 7 <br /> P:=4 t . T) pe,'/la <br /> CO ws7-x44 c-T7 d`,n,J <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �- <br /> I hereby certify that 1 have read and examined this application and know the same to be true and 5-010 <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 r f <br /> performance of construction. That I am authorized by the owner of this property to perform theEIL1 Li <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ty/ (�-' d �' <br /> ignature Date / <br /> #09/ <br /> REVISED 08/06/2014 <br />