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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 /> '7016, Be,vear l g1vci g.eAre.;14 wA 982.6)3 <br /> PROJECT ADDRESS <br /> Toy £&r'le. Noe/ C2'14 Ave SE �Ve.re 1 Wit 982.o8 (zot) 8sz-737co <br /> Own Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> l7Dl'1' eoiorter <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> �1orne,6u.WY1 EX-- goI'4towKt. <br /> �� <br /> State License Number(required)// City of Everett Business License Number(required) <br /> • <br /> Sty-1,5,‘,42.__ Fa...vYll'l Res i`c e.YI e. "/ '� <br /> Propos Use of Building I Contract Price of Work <br /> h,y Cher le✓ (zoc) gSz_737‘, <br /> L/i{Q ,s; +ro`(ebe r te.,C ✓✓of I.c� <br /> rte <br /> Square Footage(If residential new construction, remodel or addition) Contact-Person/Contact/Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: e,po,:\c"/ref(a-C-e-- ©l e ec- c -k SSte' \ et-Ad <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �O 1 <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 E I <br /> performance of construction. That I am authorized by the owner of this property to perform the SO <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 32-3 2.o' <br /> Si• Date <br /> REVISED 08/06/2014 <br />