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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 425-257-8857 — www.everettwa.org <br />.__... , , <br />�� 7 �� �. ��� �'��c�' <br />PROJECT ADDRESS <br />C�•���C(�, <br />Owner <br />Mail Address <br />City <br />State/Zip <br />Phone <br />Tenant Mail Address City State/Zip Phone <br />� <br />-�� � � . � �`Q � �� � ��- � � <br />Electrical Contractor Mail Address City State/Zip Phone <br />� �� ��� � �--� � <br />State License Number <br />� �� <br />Proposed Use of Building <br />� �� <br />Square Footage (If re .idential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: �-�-/�r,7 ��e�C� �`�, ��7 '�(2C � t� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that 1 have read and examined this app/ication and know the same to be true and <br />correct. All provisions of /aws 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 />pertormance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which application is made and I comp/y with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />REVISED 3/20/13 <br />FEE <br />��G�� <br />PERMIT# <br />E ����-0� <br />