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r , <br /> 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 /> /(Y1e). 1r/4Qr 5E <br /> PROJECT ADDRESS <br /> 4111F-- (;i.l'i---- /AZ-501/ A. . 1X-.J 7-7)1-a.1 41 Attiptile, 144-Effd- <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> f / , <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> A. aa►hs 0.e. f: 1 ;,,s°e <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) / <br /> Description of Work to Be Done: jf ff-40 J/16C/411 5inf / `/i"inc, Ite ij/re 3aii,lL <br /> 1A--ef aii^S Sol-wilts <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 6U <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 ` <br /> performance of construction. That I am authorized by the owner of this property to perform theE r <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> .7„/ <br /> 296.200 WAC. <br /> ;; 1//1 7/I/ <br /> Signature ate <br /> REVISED 08/06/2014 <br />