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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 />0 f Lk <br />PROJECT ADDRESS <br />Owner <br />Tenant 7 <br />Mail Address <br />Mail Address <br />City <br />State/Zip <br />Phone <br />City State/Zip Phone <br />P w/Ti'6500- <br />Electrical Contractor Mail Address City State/Zip Phone <br />State License Number <br />Proposed Use of Building <br />«I00o m 2+ <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Contract Price of Work <br />�j�� ���� C tl� <br />Contact Person (Plan Review) <br />Description of Work to Be Done: 112e <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 6 <br />1 hereby certify that I have read and examined this application and know the same to be true and 4 ✓ <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 C , r 0 <br />performance of construction. That I am authorized by the owner of this property to perform the E `�( Q (a5 <br />work for which application is made and/ comply wi he State Contractors Law 18.27 RCW and <br />296.200 WAC.^/� ^ <br />REVISED 3/20/13 <br />