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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 />i�" I?� �1�� �rY�"�,�" ��'�Y� .�I� �`� 2�'� <br />PROJECT ADDRESS <br />��'���SCc�" �'��,rrt� ti�Jut�i;� ��4�� ��n� �� rv�X�; , �,�� �l�Z�l <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />����� <br />Electrical Contractor <br />State License Number (required) <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />l z�� <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 />Y l�,'() �� � CJ <br />in �� _ <br />City <br />C ity <br />x <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />Ca�� ��ie ���'� � 55� ��2� �� <br />Contact Person/Contact Number/Email <br />�i n <br />� <br />���Y�� , a�� �n�UY� D��fil�e�� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <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 governing this type of work will be completed <br />whether specified h re or nof. The granting of a permit does not presume to give authority to <br />violate or cancel th pr�isions of any other state or local law regulating construction or the <br />performance of con truc"on. That 1 am authorized by the owner of this property to perform the <br />work for which appli atio is ma and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. �� <br />�V <br />nature <br />REVISED 08/O6/2014 <br />FEE <br />�j�� <br />� <br />PERMIT# <br />E1���- �� <br />�� <br />