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Jul 21 1504:43p Ivs 2538919232 p.2 <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 /> —/6-00 CV4?�C/ <br /> PROJECT"�ADDRESS <br /> Owner 1 Mall Address City State[Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> e<f Gl�. <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 /> Squar6 Footage(If residential new construction,remodel or addition) Contact Person/Contact Number/Email <br /> Z <br /> Number of devices (If low voltage) / <br /> Description of Work to Be Done-, _Set 4fry CCi1 7`�•� vf� C'<YSc=�_ <br /> i��c.2 C'� �� T cJ..i =u C-�iii•v`r 4-JQ <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 td <br /> 1 hereby certify that 1 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 otherstate orlocal law regulating construction or the ���` <br /> perfonnance of construction. That I am authorized 6y the owner of this property to perform the <br /> work for which application is made and/comply with the State Contractors Law 98.27 RCW and <br /> 296.200 WAC. <br /> SignatureLiate <br /> REVISED OaIV82R 14 <br />