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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 /> PROJECT ADDRESS <br /> oo <br /> Owner Mail Address City State/Zip Phone <br /> Tenant/rr Mail Address City^ Stated//Z`ip Phone <br /> �r r fr�:.�Y[.-'�/��� �� `�/�✓��°��.4�VG"��Y k!(r' V/V�f y�y� /JRJ�� /�'�����r��� <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 /> p 9 <br /> Zr <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: C�;�� ��✓��� J /l�r'�i�ir l /r d'�� ® /C�i /BOIr <br /> 9' <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I j� <br /> I hereby certify that l 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 l�r� <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 98.27 RCW and <br /> 296.200 WAC. <br /> v <br /> Signature Date <br /> REVISED 08/06/2014 <br />