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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 /> 1 -g, . WAD / <br /> PROJECT ADDRESS ��FF� '' ,,II r <br /> ne v �GO, <ze-i6 �veG` w4 �. -O/ 5g <br /> Owner J Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> S � ?lee-Eta;c Aav l 3,$ Lyh11 v3" � 91045 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> SYELEL f-73 3 6 O <br /> State License Number Contract Price of Work <br /> 5p1,ZIA-{- w1-Ze(ecS <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: 51'i�t �e(1 -two ek Pak1 s tlrV:Cc <br /> FEE �� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 til 0 <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 h <br /> performance of construction. That I am authorized by the owner of this property to perform the ( 3 05 cJ <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ftw 064 ete-- //� <br /> Signatur •ate <br /> REVISED 3/20/13 <br />