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• • <br /> 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 /> / % 11�r r v LJ . <br /> PROJECT ADDRESS <br /> e [dep. qq 20.3 <br /> Owner Mail Address City State/Zip Phone <br /> ( L_ <br /> Tenant Mail Address City State/Zip Phone <br /> shock t fu cj C)r -er mL,e 532-7 Z--. c AI ` C( � )( U)4 _ <br /> Electrical Contracto>' Mail Address City State/Zip Phone <br /> S11.<) d t _ 1 V-8 <br /> State License Number(required) City of Everett Business License Number(required) <br /> /2 <br /> cc•. <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) r ,j._ <br /> Description of Work to Be Done: - ri !� ,:2c) / �'G7' CO" Per / ems <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <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 <br /> performance of construction. That I am authorized by the owner of this property to perform the E 11503 - ,052 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 7////// <br /> Si nature Dat <br /> 9 <br />