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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 /> 115 hjOuilo - Ver <br /> PROJECT ADDRESS I <br /> -� 4Ls X 12 _ <br /> P6 r- <br /> V (A qoM3 <br /> Owner Mail Address City State/Zip Phone <br /> 5uoci5e— ry, (.L,e <br /> Tenant Mail Address City State/Zip Phone <br /> OBJ n-er- <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> /' I *- —AL4000 1 <br /> 110 <br /> Proposed use of Building Contract Price of Work <br /> U✓> k <br /> 2 -Square Footage (If residential new construction, remodel or addition) Cont ct Per n/Coct Num er/Email <br /> j <br /> HYu6o o�) <br /> k-64-) sun's <br /> Number of devices (If low voltage) C U� <br /> I - 1���� <br /> Description of Work to Be Done: � c NL <br /> Jiii ` � " 104 X <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 05 o" <br /> t hereby certify that/have read and examined this application and know the same to be true and <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 j <br /> performance of construction. That/am authorized by the owner of this property to perform the E <br /> work for which application is made an comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signat Date <br /> REVISED 08/06/2014 <br /> 1 <br />