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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 />-Z-� z 2 � ucic�+� �'� i/G ���� <br />PROJECT ADDRESS <br />��C..�1� t�a��:��R�Ri.=f� � t-��Cp� <br />OWner Mail Address City State/Zip Phone <br />Tenant <br />/�'1 { C��N i <br />Electrical Contractc <br />Mail Address <br />c.�.t= G, i r2<<., C`� <br />Mail Address <br />�1 CC�I�? C�Cc� � 3 IV J <br />State License Number (required) <br />L � 1.� l� � <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />City <br />CC/' �u � Q' � � <br />C ity <br />State/Zip <br />Phone <br />/ 'f2� Z �� Z,— �F� � <br />State/Zip <br />Phone <br />cU ��3 � �f CJ <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: nc Vil - '—' uN�OL.N �>=''L Lit�4-T'S tt ���� +�-�L.N U�� S;�;T<.-�- <br />f�F1�i� �- i���.�. ��bF4T� r�� D�����L� <br />i�. a�) �- Z 1� i, i C�I�T S �� t� � V czt--L -f- �-- �_�c�s ti C' �.�s. �� <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � DO (/� <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 complefed <br />whether specified herein or not. The granting of a permit does not presume to give authorify to PERMIT# <br />violate or cancel the provisions of any other state or local law regulating construction or the r�� O� J��� <br />performance of construction. That 1 am authorized by fhe owner of this property to perform the t <br />work for which application is made and I comply with the Sfate Contractors Law 98.27 RCW and <br />296.200 WAC. <br />Date <br />REVISED 08/O6/2014 <br />