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Sep. 12. 2014 9: 58AM Netversant Solutions No. 1872 P. 2 <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 /> foo c , N � o a85 � 1 eQ <br /> PROJECT ADDRESS <br /> LI 1-4ss \ S U810 �` <br /> Owner Mail Address City State/Zip Phone <br /> % 1\i\) , X005 ..,,\Nd 1?,.D v—� - 1t - <br /> Tenant Mall Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> eA143 OA c)11(V • <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building ontract Price of Work <br /> Square Footage Of residential new construction, remodel or addition) Conta' t Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done. `\,19_ <br /> eS <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 c� <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 /> C 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 i <br /> performance of construction. That I am authorized by the owner of this property to perform the E I' O-73 <br /> work for which application is made and I comply with the State Contractors Law 16.27 RCW and t <br /> 296.210 WAC. <br /> • •7 - Date <br /> r vISE008i4; 014 <br />