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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 /> if 02 340 P/ 55- 5Vece I,, 9r240/ <br /> PROJECT ADDRESS <br /> ve Doff 1//n2 3D >V SE fiver?? Cv,$ y'1201 qts yu s ' <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> ewrie K <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number Contract Price of Work <br /> 51:Jcp( � fL <br /> Proposed Use Building Contact Person (Plan Review) <br /> 750 <br /> Square Footage(If residential new construction, remodel or addition) <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: /4541/ (�/'QC�'�i"l COL/ p ane_/ 4,1 d <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 7 C 60 <br /> I 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 �t� t <br /> performance of construction. That I am authorized by the owner of this property to perform theE - Olk <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC <br /> La& I'7 1 <br /> Signature D e <br /> REVISED 3/20/13 <br />