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ELECTRICAL PERMIT AP <br />PLICATION <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 />-D-�` � i aI r) Ly - !i SCE f uticC± LJ A <br />PROJECT A13DRESS u /1 D <br />O'.vner t.ta, AddreS Dt'J Eta e/Zip phJnn <br />/�Tl1enam 'Ad I Addrea�� uty StaIrJZ P Prlore <br />Electrical Conmclor 61a I Addwbu City Statnfzlp Phone <br />(I - 5W a t,lierl f'L 1441j <br />State Lleense Number (required) My or Everett Business Licohse Number (roquned) <br />Proposed use or nodding c ractorA Price Of Work <br />Square Foo to go (II rusldontml new construction, remodel or addition) 4contacerson/Cornet Numbed[:meA <br />r <br />Numbof devices (If law voltaoe) <br />CITY OF FVFRETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the same to be Irue and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. Tho grant/ng of a permit ones not presume to givee auMonty to <br />violate or cancel the provisions of any other state or local lew rogulatlnq construotlon or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for wtwch application t*~& and I comply with the State Contractors Law IS27 RCW end <br />RC%1=08me2014 <br />FEE <br />PFRMrry <br />EHIZ-02�� <br />S <br />