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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 /> ,2 ,,/.2 % — <br /> PROJECT <br /> ADDRESS <br /> cr Oireibraotifo � W4- x.7.1 `� <br /> Own,i\e Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> / <br /> Lam/ <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> Go-00 <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 /> 3 <br /> Number of devices (If low voltage) /� <br /> Description of Work to Be Done: �s.��'S:T'—""' �t)td/�l/5 kt/' (),g,111-Stii&k <br /> ' Zidia"))/' 7e4e) 4d,kze- <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 4 51)• <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 Ell/ <br /> w{ ��� ©� <br /> performance of construction. That I am authorized by the owner of this property to perform the E <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200ii C. <br /> � c <br /> Si' <br /> at a Date (J <br /> • <br /> REVISED 08/06/2014 <br />