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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 /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip RPh.ne <br /> F&eGTiziG Po eox <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> r <br /> State License Number (required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: bLITZ-f—�l S -5 t-M(-* bail <br /> �i Z-OcJ�L <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> l 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 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 It <br /> performance of construction. That I am authorized by the owner of this property to perform the t <br /> work for which application is made and l comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Date <br /> REW SED 08/0612014 <br />