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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 8200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810' FAX 425-2578857—www.everettwa.org <br /> PROJECT ADDRESS <br /> Owner Mail Address City Stata/Zip Phone <br /> _Tenant Mall Address City State/ZIP Phone <br /> 4z5-' -811.9 <br /> Electrical Contractor Mail Address City_', StatetZip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> Ralzj '3.z- .oa <br /> Proposed Use of Building Contract Price of Work <br /> 4*04 WAt %MAGI 425'418- 130- 4 <br /> Square Footage(If residential new cohstMetion,remodel or addition) Contact PersonlContact NumberlEmatl <br /> _ <br /> Number o devices (If low voltage) <br /> Description of Work to Be Done; <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �j '*QiU <br /> I herabj certify that'I have read and examined this application and know the same to be trite and <br /> correct: All provisions of laws and ordinances governing this type of work will be completed T <br /> i whether specified herein or not. The granting of a permf does riot presume to gtve authority to PERMIT# <br /> violate orcancel 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 perform the E <br /> work for which application Is made and I comply with the State Contractors Law,18.27RCW and <br /> 288:200 WAC. <br /> _._.....--—_ I9nature ��te <br /> REVISED O$W'2014 f{` <br /> -...._.......... .�._..._...�_._._..._..._.__.. _..____ _... .. .._ _.._..._.._._....... .... .. ..7 <br /> �r-g1w I+ � <br />