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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 425-257-88&7--www,everettwa.org <br /> , 7 Lt� 201 <br /> PROJECT ADDRESS <br /> Owner Mail Address City Slate/Zip Phone <br /> Te�iant Mail Address city Slateop _ Phone <br /> X25- <br /> Electrical Contractor Mail Address 0Ky StatelZip Phone <br /> tV $SMs C}2�2 $ <br /> State License Number(required) City of Everett Business License Number(required) <br /> A?A VoMEAT &EmM&- 4.32-5 .®o <br /> Proposed Use o"f Building Contract Price of Work <br /> N 43 wAC%WM q2-15,238- 1764 <br /> Square Footage(If residential new conWirk ctlon, remodel or addldon) Contact PersoniContact NumbertEmall <br /> _ 0 <br /> Number o devices(if low voltage) G An <br /> Description of Work to Be Done; <br /> FEE __.�-------- <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 0c, <br /> I � <br /> I <br /> h&&bY car*that I have read and examined this application and know the some to be true and <br /> correct: All provisions of laws and ordiftances governing this type of Work will be completed - -- <br /> whetherspeclfred herein or not. The granting of a permit does not presume to give euthoflty to PERMIT# <br /> violate orcar)mi the provisions of any other state orlocallow regulating construction or the <br /> performance of constfucttbn. That i am authorized by the owner of this property to perform the <br /> wont for which application is trade and l comply With the State Contractors Lav✓98,27 RM and <br /> 286^200 WAC <br /> t <br /> gnafure t7ate <br /> REVISED 0&V6&f4 <br /> E_ ___._ _.____ <br />