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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 /> Atli w&y t t . <br /> PROJECT ADD S <br /> Ctti . -DAR teGe .1:1SO Vi chi Blv4. e O4 C ' 'l%1 3(aO-4O3-5slg <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> twiittekittivic vet ioncox4W S-4,31.1/ <br /> Electrical Contractor Mail Address ey State/ZipPhone <br /> Pouse.41 0. .c2 <br /> State License Number(required) City of Everett Business License Number(required) <br /> (1)1.Si t ki oA $1110.00 <br /> Proposed Use of Building Contract Price of Work <br /> &VI <br /> 5(00 <br /> Square Footage(If residential new construction,remodel or addition) Contaid" else /Contact Numberm , ,. cool <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: `Yt �t1.TUUtAn A ,lib.,fitral Tover6d 4vvi1 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 OP\CO <br /> I herebycertifythat I have read and examined this application and know the same to be true and <br /> Pp <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 t 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 /> Signature pati <br /> i <br /> REVSET)08,0ti/2014 <br />