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ELECTRICAL PERMIT APPLICATION <br /> CITY F EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> 1;30\ \1n COn. ccke_ o <br /> PROJECT ADDRESS v ec e�k; \ 9 a.o3 <br /> 1'Lut rcv- Phase 1, LLC. ted-V V - S ASO S ec,tHt., 8 <br /> Owner Mail Address City State/Zip Phone <br /> 4k&c r s U..c CSot cave. W Ever irk. a; Q$Zo3 <br /> Tenant Mail Address City State/Zip Phone <br /> Cfk/e4 (1:P ';e. 710•, 4//02-- g PA A(4A(41/ 14J <br /> G - 4t/4. 7BGn1 2c; <br /> r <br /> Electrical Contract Mail Address City State/Zip Phone <br /> (-/A'/I/ / 06 fP QSz7�y� <br /> State License Number(required) City of Everett Business License Number(required) <br /> t,Jac eYwv�c l oc c Life_ { <br /> Proposed Use of Building Contract Price of Work <br /> veeya <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number Em 'I <br /> 7 3 ”(7—5- <br /> Number <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: I-c do//lye— i - 47 ,- carr-r�v+o/M ;l e.7 /HAir( 1 <br /> FEE <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 /> U <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 O O�� <br /> performance of construction. That I am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 4111P <br /> / <br /> Date <br /> REVISED 08/06/2014 <br />