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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 /> PROJECT ADDRESS <br /> r F/) - Pcvkf /-, cd(;�' <br /> Owner Mail Address City State/Zip Phone <br /> �Ov;, 1 ck'\t c! )- i -�-- {— <br /> Tenant QMail Address City State/Zip Phone <br /> '77 t'-�&ck?-cel ` r�,�5 ��Z3 s (-A ze S>% ; L 4i� '?Ylol Z06-s <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 77 <br /> � <br /> Slate 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 /> Description of Work to Be Done: <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 5_ O <br /> 1 hereby certify that I 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 <br /> performance of construction. That I am authorized by the owner of this property to perform the E1403- <br /> work for which application 's made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 W <br /> Signature Date <br />