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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 425.257-8897—www,everettwa.org <br /> PROJECT ADDRESS <br /> S N CN A 0 <br /> Owner Mail Address City StatefZtp Phone <br /> Tehant Mail Address -fty State/ZIP Phone <br /> Ve <br /> �{25�??�-8 J►.q <br /> Electrical Contractor Malt Address City'` Statei2lp Phone <br /> TtVe-*-0n 02.6 2.14S' <br /> State License.Number(required) City of Everett Business License Number(requked) <br /> A?Pr&- &JT gEmM 4 32 3 f�C <br /> Proposed Use 6f Building' Contract Price of Work <br /> MA TN A13 (AJA 1,.1 A•yAA1 '42-5-Z18- t q&- 4 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact NumberiEmall <br /> _.._._�0 <br /> Number o devicesIf low volts ge <br /> t ) , <br /> Description of Work to Be Done: A� �✓ ' .� —T_ <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerdty that l have read and examined this applicaffon and know,the same to be true and <br /> correct{ All provisions of laws and ordinances governing this type of work will be cornpleted --- <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT f <br /> violate or cancel the provisions of any other state orlocal law regulating construction or the <br /> performance of construction. That i am authorized by the owner of this property to perforrn the E <br /> Ark for which application Is made and I comply with the State Contractors Law 18,27 RCW and <br /> 296.200 WAC. <br /> _ S gnature f5ate' <br /> rmftEo 0610$120 14 <br />