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I <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 /> ll (r CCF 0 r L. <br /> PROJECT ADDRESS <br /> gy <br /> Owner V Mail Address City State/Zip Phone <br /> �"1-k <br /> Tenant Mail Address City State/Zip Phone <br /> �C" 0 1\ y- 6 y I <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> � N70(--) 100 <br /> Prop so ed Use of Building Contract Price of Work <br /> Spvl �z k' ' �^ <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: L ,4 + `� ,1 )Q\CYj <br /> t O <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 <br /> performance of construction. That 1 am authorized by the owner of this property to perform the l r <br /> work for which application is ma and/comply with the State Contractors Law 18.27 RCW and 1111 <br /> 296.200 WAC. <br /> 11/ <br /> Sign a Date <br /> REVISED 08/06/2014 <br />