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ELECTRICAL PERMIT APPLICAT ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810 - FAX 426-257-8867—www.everettwa.0179 <br /> 'L :51- E =Ej-r WA382-01 <br /> PROJECT ADDRESS <br /> �SW <br /> Owner Mail Address C4 Statelzip Phone <br /> Tehant Mail Address city State/Zip Phone <br /> t4z5-,,7,*-811-9 <br /> Electrical Contractor Mail Address city staterZip Phone <br /> "tV� X150?_62q$ <br /> State License Number(required) City of Everett Business,License Number(required) <br /> - a? <br /> Proposed Use of Building Contract Price of Work <br /> lJATMNI WALT� J q2-C;,-218- 1704 <br /> -Square—Footage-(if—residential new consaMil—on, ,remodeloraddition) Contact Per8on[Contact Number/Email <br /> /A <br /> umber O0 devices If low voltage) <br /> Description of Work to Be Done: <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 t 1:5 <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 /> wheffier spec/fled hereln or not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cuncel the provisions of any other state or local low regulating construction'or the <br /> performance of construction, That/am authorized by the owner of this property to perform thq <br /> Work fdr which application Is made and t comply with tho State Contractors Law 18.27 RCW and <br /> 296,200 WAG <br /> 5-19- IS <br /> 5 nature pale <br /> —------------- <br />