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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.gov <br /> -�� �j2c`��► l� w�� ��r, <br /> PROJECT ADDRESS <br /> iz Jar&C'f'7-T <br /> s��lv�� L (�.Tsiy�.F—c I �z✓r„4 l.>� FE���� y�;_��.` �. �� <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> V,4 11 c:o - �� ,�-1� < k u y �rz- �<17 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 1/i4 /1 Cil C 141 <br /> StateLicense Number(required) City of Everett Business License Number(required) <br /> ,4q 7; ,d_ <br /> Proposed Use,. (<r�o`f Building Contract /Price of//Work <br /> �`� (/�lG (.soJEc� Nss AZT-47Y <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> lM1 icvE v-C' ✓iE-k,r,-rc ,c o <br /> Number of devices(If low voltage) tt <br /> � <br /> '> q I�z.1��r�S-TtLc-� <br /> Description of Work to Be Done: �{/ �' A« -3 OT1.4- <br /> fzFr l �.� �) G-�l�r�+- %3,� l l�s �^- 17'1-�-��G- ���t(lam sr— <br /> (--2) <br /> r— <br /> (om) A 13 o v¢ <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> /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/am authorized by the owner of this property to perform the <br /> work for which application is made and l comply with the State Contractors aw 18.27 RCW and <br /> 296.200 WAC. <br /> Signat re D to <br /> REVISED Oa/062014 <br />