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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 /> � �'�' � �� � ��t� J'�1/�� <br /> — , � �, � � <br /> , , � - �? � . �, <br /> 7� , ^ - <br /> � - C��_� � �_�.._ --�- �v�� e-f�� �J ������ l <br /> � <br /> PROJECT ADDRESS <br /> '� ' '� 'I <br /> �;-G�,:i�n��/` ����i,r`/✓ t �f\P_L�iCC;- <br /> Owne� Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> �r('l� �lzC��:�, �� �c��( �%�`�I(:;-� ���;-4-� �C G�.:i� �i�IC� ll�•43�-5Z�,�:- <br /> Electrical ContfaCtor Mail Address City State/Zip Phone <br /> �/�Ltrt CC=� ���- r�v (_�r�yc�k� <br /> State License Number(required) City of Everett Business License Number(required) <br /> �T:� l'� �2) <br /> e� � , � � — <br /> Proposed Use of Building Contract Price of Work <br /> _�t�c�� ���nc;-�,,�„l�� ���--�i:u-��'3f' <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (if low voltage) <br /> ��_ �cr��c,�.-I- ��\ ��r lter �� �,-tn;,��tc. <br /> Description of Work to Be Done: �P � <br /> , <br /> ` > ` `�. � ' <br /> � f��. ���'?�Y � f�L� �L�'��� ���^j1��WL�� , r J hn ���l 17-�-t✓1�-.�� y��.Y'!� � — <br /> �� � ' l'��(�Z+' <br /> -� �"L ����i,,, �-� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �C�/� V� <br /> l� <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances goveming this type of work will be completed <br /> whefher specified herein or not. The granting of a permif does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any ofher state or local law regulating construction or the <br /> performance of constructron. That I am authorized by the owner of this property to perform the E ��j ��—oGj� <br /> work for which application is made d 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.2�0 WAC. <br /> , <br /> ��✓' � �JC�r��Nr�' � � 1 (;;� <br /> Signature ate <br /> REVISED 08/O6/2014 <br /> I <br />