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From: 08/28/2014 09:36 #055 P.002/002 <br /> • • <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 /> 60(47;,) Eve ---57 ` CgC,0 C''7 otagii, C R'r5 r,'t.- M ac.}41NC_ <br /> PROJECT ADDRESS <br /> `TA-t; Qarrxl6 torr t,0 y <br /> Owner Mail Address City State/Zip Phone <br /> CZ. <br /> Tenant Mail Address City State/Zip Phone <br /> (.tD)rri2CoL D r.Jft wt tt_.5 •11,1e.. 71 E. vJrs Vitt 242 c�V -n L i A-./9432D t 42S 5/3 4014f <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> Po 1J-rizbm <o t 7 <br /> State License Number(required) City of Everett Business License Number(required) <br /> clt <br /> /6 zip.c�c7 <br /> Proposed Use of Building Contract Price of Work <br /> �Att VD�Ni 204-81?- 219(,2 <br /> Square Footage(If residential new construction,remodel or addition) Contact Per on/Contact Number/Email <br /> #4142,p1,-1 @ CDSNu .CaNA <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: Aim 11V f tP o' -' T c 2 AA„Phzp u t &1 Dj <br /> FEE �j� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 i� / _ S vC7 <br /> I 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 r <br /> performance of construction. That lam authorized by the owner of this property to perform the ENDS LL D S- { (0l 1 <br /> work for which application i made and I comply with the State Contractors Law 18.27 RCW and , bb <br /> 296.2u WAC. <br /> 8/7. x, <br /> Signatur Date <br /> REVISED 08/06/2014 <br />