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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />320� CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />`� � C.� �p C��er t� ,� �� �j " �, �2 ��,�'� <br />PROJECT ADDRESS �� � C <br />Owner <br />� <br />r � <br />Tenant <br />Electrical Contractor <br />State License Number <br />Mail Address <br />(i � �W� �i <br />Mail Address <br />Mail Address <br />�' �i �'r.� t�,.� � <br />�G- �//�y /l.. �, " � -7-�---/`���(' �fi �G,� <br />r��L <br />Proposed Use of Building <br />Z'� GU <br />Squar Footage (If reside tial new cons ruction, remo I or addition) <br />Number of devices (If low voltage) <br />of Work to Be Done: <br />4 <br />City <br />wto v��,�, Gl�2C—� <br />State/Zip i}�� �'7�I?�. ��, � <br />``C � I <br />• � V��c� Il� �' � �Z� � <br />City State/Zip�� /j ��ne <br />��� � <br />City <br />State/Zip <br />Phone <br />Contract Price of Work <br />Contact Person (Plan Review) <br />. <br />vV` �%1, �� .! � 1 <br />� �la �o����� � � ��� <br />��.,,� �G�,�.S �1-� � --� � �d � --- �� [ <br />� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that l have read and examined this application and know the same to be true and <br />correct. AI! 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 nof presume to give authority to <br />violate or cancel the provisions of any other state or loca/ law regulating construction or the <br />performance of construction. That ! am authorized by the owner of this prope►ty to perform the <br />woric for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. ,� <br />//%lii�.�/�'1...�.- � I � I r � <br />REVISED 3/20/13 <br />f� <br />FEE <br />� <br />�� <br />PERMIT# <br />E ��.�-_ <br />� 13�5 �- L5 3 <br />UY�'S� <br />