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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 /> 152'/ Pp.tn.tjr Imo, <br /> PROJECT ADDRESS � C .ts 55- 0H2-7 <br /> 191,‘i 4v1 oA 9/ '` G36 VI I 0 , 1V ,inr2, I1 �a �giz--)5 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> E.,wc k c t/a r(6 1011S Civ nwooa A JJJ. WA- °I5'173 ( ,c-I'3Lf-6 31 IS <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> E)xhcT E L92:7 PK CSS 12v5 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building ontract Price of Work <br /> 1 IS 00 Pk\ 0-izs).555- qit 23 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> V <br /> Number of devices(If low voltage) \\w\ <br /> Description of Work to Be Done: �e c.0) CSVf.h aot.3 f l�CJ ,C(G'^^ 240 v I lo J <br /> CAV\) J <br /> 1 <br /> ten) o%) FC'1 ‘r. PpA;sVh 1:1.0vGs /4/0,.‘r & ro 1A• <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 4 1 5 09 <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 <br /> performance of construction. That lam authorized by the owner of this property to perform the E i lD S 2� <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WA . <br /> If G//7 <br /> Signa reD to <br /> REVISED 08/06/2014 <br />