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s <br /> ELECTRICAL 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 /> 22D1 LoA4 15A-RD A.vi EVfR£T+ , CdA <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> hwir iTY gzarge- S P18 134"in SE AlrWC45TLE f8os9 2063X.3g2B9' <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> iuP/vCs 971(2 JS' /s"OO <br /> State License Number 66tract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> 2000 <br /> Square Footage (I residential new construction, remodel or addition) <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: R E. W/ R! AlCr- <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and examined this application and know the same to be true and v <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 presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the r a I J <br /> performance of construction. That/am authorized by the owner of this property to perform the t U�I <br /> work for which applicatio�P made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 W <br /> — nature Date <br /> REVISED 3/20/13 <br />