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AWL <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 /> W7 ( a / ey <br /> b <br /> PROJECT ADDRESS <br /> W4 9Y/33 At,4�0-�rji <br /> Owner Mail A dress fl City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> f Ju <br /> State License Number(required) City of Everett Business License Number(required) <br /> Alk <br /> Proposed Use of B ilding Contract Price of Work <br /> 0 1A <br /> Square Footage(if residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> 111' ! <br /> Number of devices (If low voltage) I / / <br /> Description of Work to Be Done: .f � l! PV e —I � Iln e 'n rn-le 4YJ I- 1 co' &M,01f <br /> . I I —T—P <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �-1 15 DO- <br /> /hereby certify that IF 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 f _ <br /> performance of construction. That I am authorized by the owner of this property to perform the "J LV <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC, C I <br /> 0,x� P. / Ld r Itl J <br /> ignature Date <br /> REVISED 08/06/2014 <br />