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04/10/2016 21 :55 #0265 P. 002I002 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 88201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> PROJECT ADDRESS � v <br /> Owner Mail Add(ess City State/Zip Phone <br /> Tenant Mail Address City Statelzip Phone <br /> po <br /> — <br /> Electrical Contractor Mail Address � city State/Zip Phone <br /> W412-0 0 :1 (a3 � 3 <br /> State License Number(required) City of Everett Business License Number(required) <br /> JIFA, <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 /> Number of devices(If low voltage) <br /> Description of Work to l3e Done; <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 11 <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 As 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 O�� <br /> performance of construction. That I am authorized by the owner of this property to perform the E <br /> work for which app "tion is made and l comply with the State Contractors Law 18.27 RCW and <br /> 296,200 WAC <br /> Y/// <br /> l <br /> / ndfure Date <br /> SUDW6a"014 <br />