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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 />/�/� - � ��7� Si <br />PROJECT ADDRESS <br />J� r� �l�x / s�i� �;'.�{ s r ��'��2�:,— <br />Owner Mail Address City <br />Tenant <br />Electrical C <br />Mail Address <br />� I� C'i ��'� 5�(0� -�?. �, S` Si.J <br />� �,� / �� :ro ���:� <br />State License Number <br />,� <br />/� ..�' S ; <br />Proposed Use of Building <br />Mail Address <br />City <br />(/lf! /T <br />C ity <br />Y��,��� �; <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />r�a- <br />State/Zip <br />State/Zip <br />P�J'� �' �"d N 3 <br />State/Zip <br />��o�� <br />Contract Price of Work <br />: �4.4� � <br />Contact Person (Plan Review) <br />Description of Work to Be Done: �_ww'.i �- �1 ✓��b "�~� ���- � C��--c� �, �� a�L �— <br />W ;�`-. �ov�-ek, c�.�P l �� ? :.,. �� ,Y �t.,�..z \ , <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 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 herein or not. The granting of a permit does not presume to give authority io <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />pertormance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which applicafion is made and I comply with the State Contractors Law 98.27 RCW and <br />296.200 WAC. <br />ature <br />REVISED 3/20/13 <br />Phone <br />Phone <br />Phone <br />FEE <br />� - � t:� �� � <br />PERMIT# <br />E � �� �: - � ����; <br />