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- <br /> ELECTRICAL . IT APPLICATIS <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 /> 6'q 8,✓e4-)y f9/pl <br /> PROJECT ADDRESS <br /> }r1/l`e Yyrjel �y R 4y � E f -( 5 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> C/c 4'5 I/mac 7 / �-'- i,'1.✓ ��w x r 1.{/ %��� 122-7--;1C-0 ? 2.Electrical Contractor Mail Address City State/Zip Phone <br /> • <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building ontract Price of Work <br /> c -rI WS' 76o-q.r- <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) y <br /> Description of Work to Be Done: )Catik'7 .x'11/Lce ci74 z 3C)/0 � Phi lb' <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 r CO <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 D� <br /> performance of construction. That I am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Date <br /> REVISED 08/06/2014 <br />