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• <br /> ELECTACAL 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 /> �. <br /> 7-7- �.�e r� -c C i/tel'33 -a��'„' rI. .y G�Y.q�C M619 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> a.53 <br /> 1.4�4e,W,!C ib.�s 9D 9 .S- e2d' Y/��►17u 1dy6 g -f 73 33-�Za <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> f�� 7 <br /> irl �o yGtS /s-D �� <br /> State License Number Contract Price of Work <br /> .(�4-.7, Z- <br /> ��,�.�• Gu m y <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage (if residential new construction, remodel or addition) <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: <br /> Av <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> C. <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 presurne 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 1 ts'n 5 <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 3/20/13 <br />