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09-09-15;03: 38AM; # 1/ 1 <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.gov <br /> S 25 q 3 ro( S+re_e.`I' <br /> PROJECT ADDRESS I)pier <br /> &rk i; def✓,`ce Lvtrelf c (-1n:-dd <br /> Owner mail Address City State/Zip Phone <br /> Tenant Mall Address City State/Zip Phone <br /> F //2e- Ft ed t )7_zo S. 3s 4-1- 51 Fec l er,,,t g063 2.33 4U 7/ <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> Pk)LA.S 3.. Do0.0 <br /> Proposed Use of Building Contract Price of Work <br /> ZeM-ocLZ I fa y Fu l/e!' a06-V-2-3-83 <br /> Square Footage(If residential new construction,remodel or addition) Contact Person/Contact Number/Email <br /> 11 l P4,Hy 61./ /kee.le�,co, <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: j e i^'t oG{�-/ -For ADI NCS 1/ 8 KFC py',. dee/c00", <br /> • <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 t°49 <br /> I hereby certify that I have read and examined this application and know the same to be true and VV <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 lam authorized by the owner of this property to perform the E 15061 012 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Date <br /> REVISED 0W062014 /�1' !Ccl.( / / L� PaY �� <br />