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�� �� �� � � , � �� ��������� <br />�0�� �� �V����� ������ ����'��� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� � <br />PROJECT ADDRESS <br />� <br />Own e r <br />Tenant <br />Electrical Contractor <br />Staie License Number (required) <br />� �� <br />Proposed Use of Building <br />, <br />Mail Address <br />Mail Address <br />Mail Address <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />City <br />City <br />State/Zip <br />State/Zip <br />N <br />. �. <br />r.�;�i. <br />� <br />Phone <br />Phone <br />City State/Zip Phone <br />f �1 ,,1��� SS <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />Contact Person/Contact Number/Email <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �(�j �� <br />e <br />I hereby certify that 1 have read and examrned 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 ! am aufhorized by the owner of this property to perform the ���� r 1 Z� <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />re <br />REVISED 08/OG/2014 <br />Date <br />