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• <br />2063674575 p 1 <br />s <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />32CO CEDAR STREET, EVERETT, VJA 98201 <br />425-257-8810 • FAX 425-257-8857—www.everettwa.org <br />'; V2-S Cab-\ —N-L <br />PROJECT ADDRESS <br />CwnA( Will Address Cdy State/zip Phone <br />('V <br />Tenant Mail Address City Stale2ip Phone <br />3S0&41 k,)A gUm <br />Electribeacintractor Marl Address Qly Stale/2'p Prone <br />State License Number (required) <br />Proposed Use of Building <br />Square Footage (If residential newconStlUWon, remodel or addition) <br />Number of devices (If low voltage) <br />Description of WoM to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />G-2'2 Iq-1 <br />City of Everett Business License Number (required) <br />Contract Price of Work C7tb) <br />Contact PersonicontabiblumberlEmail <br />I- 2 - ovu� <br />I hereby certify that I have read and examined this application and know the some to be We and <br />correct. All provisions o$aws and ordinances governing thr3 type of work will be completed <br />whether specified herenrornot . The granting of permit does not pmsume to give authority to <br />violate or cancel the provisions of any other state or local law regulating constnichon or the <br />performance otconstmchon. That I am authorized by the owner of this property to perform the <br />work for which application is made and I Comply with the State Contrac!ors Law 18.27 RCW and <br />298.20 WAC <br />nrvaeyoaesaou <br />FEE � � O <br />PERmrr# <br />