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ELECTRICAL PERMIT l�►PPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />/� 0.� 5 � Eveie7i/j?A!l t14�L _ <br />PROJECTADDRESS <br />Owner <br />Tenant <br />Electrical Contractor <br />Mail Address <br />Mail Address <br />Mail Address <br />J"gr ec.Es $ � 3 $.�- <br />Slate License Number <br />p . <br />nC <br />Proposed Use of Building <br />eJ 0 ap 0 <br />Square Footage (If residential new construction, remodel ar addition) <br />f�umber of devices (I� Iow voltage) <br />Description ct VVork to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />City <br />City <br />City <br />StatefZip <br />State/Zip <br />� 7G�37 S17• <br />S�ate/Zip <br />��{9700 0 <br />Contract Price of Work <br />Contact Person (Plan Review) <br />1 hereby certily lhat I have read and examined this application and know fhe same fo be frue and <br />conecf. All provisions of laws and ordinances goveming this (ype o/work will be completed <br />whether speci�ed herein or not. The granting ol a permit does n�t piesume to give authonty to <br />violate or cancel the prov s o/any olher s(ate or local lav� regulating construction or fhe <br />peAormance o/ const ction. That I am aufhodzed 6y fhe owner ol this propeRy to per(orm (he <br />work lor which appli fion is made and ! comply with fhe State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />FEWSED 7l10/I7 <br />Phane <br />Phone <br />Phone <br />FEE <br />�I-`J 0 �- v� <br />PERMIT# <br />E i`fOf- IS`f <br />P <br />