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ELECTRICAL PERMIi APPL9CATION <br />CITY OF EVERETT PERMIT �ERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� ��' 2 �� s� l�%�� <br />PROJECT ADDRESS <br />��, v' r (i� �� '� � .h , i,�s � � <br />Owner <br />Tenant <br />C� 1�V Y� �%� <br />Electrical Contractor <br />Sfate License Number <br />� <br />� ,, ���� fi�- �, �. `-� �' � � � <br />Mail Address <br />Mail Address <br />Mail Address <br />S I�1��, <br />Proposed Use of Building <br />� `/Sc. <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />City <br />City <br />City <br />State/Zip <br />State/Zip <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Phone <br />Phone <br />Phone <br />Description of Work to Be Done: (\ e�'l'� ����'�� °�� K,�/`� "��'� �`�p L S/�% /P V�` ��L'�_ <br />lN; �_� ��� (j��, �-�'�/� ('G ��: (G,/r,,�j �,Gy,�Y �j /'�v7 v� �c c� (,�/',1����v�c� 0 '''�`� h � L,�'— � /l� �i� �l <br />�� <br />� !���- �,n �'� f'� �Cl�,��.� �I�� �-, <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I here6y certify that l have read and examined this applicafion and know ihe same to be irue and <br />correct. Al1 provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or nof. The granting of a permit does noi presume fo give authority to <br />violate or cancel the provisions of any other sfate or loca! law regulating construction or the <br />performance of construction. Tl�at I am authorized by the owner of this property fo perform 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 />� �>' _- � �• ( �- <br />���.� �// <br />ure <br />FEE <br />! � <br />U <br />PERMIT# <br />E I �} (; � � � �C� <br />