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Aug. 24. 2015 2: 32PM No. 0805 P. 1 <br /> 1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425257-8857—www.everettwa.org <br /> • / ..�_ .. # 0 s/ <br /> PROJECT ADDRESS <br /> &IA" n7h r39. <br /> 9JO 7 . J-S-- /r.o ? 94 <br /> Owner Mall Address Oily Slate/Zlp Phone <br /> i/./' .iii <br /> Tenant / Mall Address City State/Zip Phone <br /> Tieifigibean-- lqo LovAivi 4-ItegD .11 /A et,f1; ki <br /> cal Contractot Mall Address City State/Zip Phone <br /> 1—� 6d'i M acgo <br /> S a LlcenseNumber(required) City of Everett Busln as License Number(required) <br /> CAA ini2a1/11/ :.'"d 501-0,, -----" <br /> Proposed Use of Building Contract Price of Work. • ' <br /> 'T . jSquare Footage(If residential new construction,remodel or addition) Contact Par/ 6-143eiebide.1710 <br /> /Contal <br /> OfU� CO -Cern. <br /> Number of devices(If low voltage) ��pp ,, <br /> �� <br /> Description of Work to Be Done: `�"N r +. <br /> �, .--34=T C �874e <br /> • <br /> • <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3108 1,0 i <br /> /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 slate or local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the E 150 I?, <br /> work for which application is made end I comply with the Stale Contractors Law 18.27 RCW and <br /> 298.200 W•C. <br /> r e01Signalur;% Vi4'&5 <br /> REVISED 08/05'2014 <br />