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• • <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 />� L� T� � 1 �•� I"l c� �` � I--f �.�+ f��� 1 �yc-i . <br />PROJECT ADDRESS <br />.;L���, 7 _3�� .- <br />� ^ � 1 d t"!1 L � '� � d ,� ( Td+S-�� �i " ' " � �%' <br />��C�, 'vv�.c , Cl r�i 1 C�'�'I (� Ni K� 1-F l� �� L- l t'� c� L� ,� �� <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />�,��., t1'E�t <br />Electrical Contractor <br />Mail Address <br />Mail Address <br />-��� C ��:� �'� � ��.-.� <br />State License Number (required) <br />�-: �� t' �1. �C � <br />Proposed Use of Build g <br />1 �� <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />City <br />C ity <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />• 1' YY\<<U�=�y C��i 'C'n�v °c�Srt. llE� <br />Contact Person/ ontact Number/Email <br />�G��, ���3G �ll0�2 <br />Description of Work to Be Done: .I. �..;� 4� �� �� �. ��:-t.t- � 1�1.� ��c-L t�-i ' �� L�� g' .(•-� b. " rj <br />�J <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 310� <br />I hereby certify that 1 have read and examined fhis application and know the same to be true and <br />correct. All provisions of laws and ordinances governing thrs 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 state or local law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this property to perfonn the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />�.� t� . 1�\�c <br />nature <br />REVISED 08/06/2014 <br />���-�- IS <br />uate <br />FEE <br />�� � <br />PERMIT# <br />E (� jZ.��c��J <br />