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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETTPERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 58201 <br />425-257-88W FAX 425-257-8857 — www.everettwa.org <br />PROJECT ADDRESS' <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor Mail Address City State/zip Phone <br />rl-� Z '*-O l <br />` State License -Number Contract Vrice. of Work <br />Proposed Use of Building Contact Person (PI n Review) <br />Square Footage (if residential new construction, remodel or addition) <br />Number of devices (if low voltage) <br />Description of Work to Be Done: <br />FEE <br />CITY OF EVERETT LOCAL SALES'TAX CODE IS 31.05 25 O <br />l hereby certify -'that f have read and examined>this application and know the same to. be true -and c/ <br />correct: Ai provisions of laws,,and ordinances goveming this type of work will be cornpleted <br />whether specified herein or. not The granting of a p'ermrt does not presum- a to give authority to PERMIT# y <br />violate orcancei the provisions of any otherstate or local law:regulat(ng constrUCUon orthe + 0� performance"of construction. That l am authorized by the owner of this property to perform the E 140 3 <br />work for ation_is°made and i comply with -the State Contractors Law 18,27 RCW and a <br />296 A WAC; <br />Date _ _a <br />iure - <br />