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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 /> /0, 13 '111'1// <br /> 9oP <br /> jz�0 le�� s . _ <br /> PROJECT ADDRESS/ <br /> Owner Mail Address City State/Zip Phone <br /> 0/I/ 4 "We 4 ' A/ 73 <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Q T ,ditweiev/44, <br /> Square Footage(If residential new construction,remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) �� p' r <br /> of Work to Be Done: (104 [7 6 Z/C� "7 /------7/ /,6-45- <br /> Description f` <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ��✓ <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 p� <br /> performance of construction. That I am authorized by the owner of this property to perform the E 14 ) I - V <br /> work for hich application is made and I comply with the State Contractors Law 18.27 RCW and I <br /> 296.200 <br /> A A �� <br /> -/1/ <br /> Si <br /> 9;tv Date <br /> REVISED 08/062014 <br /> II <br />