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• , <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 />, D \ --S k,D v),\,\jc),,A- A, . ....() <br /> PROJECT ADDRESS <br /> CLAN-I'S.e_ N.&\I ( c).4 ) Doq wky__s3 1 Ndd-e_D (IDefiL P -n <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> OW iteX <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> Number of devices (If low voltage) <br /> D--_ iption of Work to Be Done: <br /> r ( _ <br /> .i 454.--. 0-4 N--Lo &0-.6211--- -- 2'1- Yvt6-0-e —\--D ().- - -42- e-d-12-Q-- , <br /> Q A t-v-t _ <br /> 66 4-0 vw-,) c, J a ?,_40 _ 1 C�-,C�(.6�r.L_ c,tkaa.e' 1 utiti&. <br /> r <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 `-c/ it-C) 6 <br /> I hereby certify that l 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 state or local law regulating construction or the I r <br /> performance of construction. That I am authorized by the owner of this property to perform the E 3( ( `� <br /> 5 <br /> wojr�_trr wh. application is made and I comply with the State Contractors Law 18.27 RCW and ll \ <br /> 96.200 WA• <br /> ... 7/1/4//k_-. <br /> •nature <br /> fDat <br /> REVISED 3/20/13 <br />