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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 5 `q -1 3 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org E / 30 S _ OSl <br />?i n s o C� SQL <br />PROJECT ADDRESS i <br />Owner Mail Address City Statemp Phone <br />_►�\ 9`6 L-- <br />Tenant Mail Address City Stateop Phone <br />Electrical Contractor Mail Address <br />!40 E-`,- t Zlo V- <br />Slate License Number <br />0" c-.(;—, <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />City <br />state/zip Phone <br />in 3g I <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Number of devices (If low voltage) r, <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that 1 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 o/ a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance o onstmction. That 1 a uthorized by the owner of this property to, the <br />work for hich plic ion is ade an comply with the State Contractors Law 10.27 RCW and <br />296. WA . <br />ateseo aMa <br />FEE <br />•;�C` 1 C <br />PERMIT# <br />E; <br />k7a <br />