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� � <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 />�a �� 4� i� f� I� �� o� � v� ;� v��-�c��-� c.0 ����c� 3 <br />PROJECT ADDRESS <br />� ��r� �. I-{��'s« <br />Owner Mail Address <br />City <br />State/Zip <br />Phone <br />Tenant Maii Address City State/Zip Phone <br />�}� Z S-� <br />F�o����,� �.�e� �tc �Y��3 �(�t�l s� �=t= - ��r s���<<I�e �.::�� ����� �s�/�s <br />Electrical Contractor Mail Address City State/zip Phone <br />/�G c�. �'�= �2%� � `� 1 � � <br />State License Number (required) <br />Proposed Use of Building <br />,, __ <br />l.�� �- C'�` �� !--� <br />Square Footage (If residential new construction, remodel or addition) <br />.� <br />Number of devices (If low voltage) <br />Description of Work to Be Done <br />��' c:.�:� � C� J` dLP L�< <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />-���;3rt��- <br />City of Everett Business License Number (required) <br />� S�iU °'-. <br />Contract Price of Work <br />Contact Person/Contact Number/Email <br />/ i'� t� <br />! hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances goveming 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 <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and ! comply with the State Contractors Law 98.27 RCW and <br />296.200 WAC. ---- <br />, -- —� <br />--- �---_ <br />y:;� ---- _---�----- � <br />` _ � �S`���7� 2O� S <br />, �, (� �— - <br />REVISED 08/06/2014 <br />FEE � �� <br />� � <br />PERMIT# <br />E ����-�3� <br />� <br />