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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 />� <br />a�� ` �- �� �� <br />PROJ�CT ADDRESS _ <br />er <br />Tenant <br />Electrical Contractor <br />State License Number <br />�✓ C� <br />� � <br />Mail Address <br />Mail Address <br />Mail Address <br />_L <br />, <br />City <br />C ity <br />C ity <br />���� <br />Proposed Use of Building <br />��� <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: �"�� (� � C- <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />G <br />%�2 `Q .�/) <br />State/Zip <br />���� ��s �� <br />State/Zip <br />State/Zip <br />a�'�� <br />Co tract Price of Wor <br />L � � c� <br />Contact Person (Plan Review) <br />�i� i%G d'�i' <br />1 hereby certify that I have read and examined this application and know the same to be frue and <br />correct. AlI 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 <br />violate or cancel the provisions of any other stafe or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of fhis property to perform the <br />work for E�ieFra�n7s- de and 1 comply with the State Contractors Law 18.27 RCW and <br />296 0 C. <br />-� �" /� �� <br />re <br />REVISED 3/20/13 <br />Date <br />Phone <br />Phone <br />Phone <br />FEE <br />�'"? C.: �; <br />(� <br />PERMIT# <br />E t�,) - ��� - C�� ( <br />