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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETTo WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� UZ�L � �'�-✓ ►�v`�- �l-� ✓� <br />PROJECT ADDRESS <br />6��'-}— C.�w-c ( � �u2A- ��2� �Zv�l �w ✓-�-�-� -�� L���', �,�- i �Z� ( <br />Owner Mail Address City State/Zip Phone <br />�� <br />Tenant <br />� <br />Mail Address <br />�r��e�i'R� � Z ZUZ � (� �`' <br />Electrical Contractor Mail Address <br />��� I �O�Q�33 ��' <br />State License Number (required) <br />�1�..x�, �Yt�..� � �.�� <br />Propose Use of Building <br />n1 � �-- Cc� ►nn�'�-v�1�- (� <br />Square Footage (If residential new construction, remodel or addition) <br />3 <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />(���n,e L . � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />� �. <br />C ity <br />State/Zip <br />Phone <br />) [.2.�.�, �,�i- �K� 3 Z <br />State/Zip Phone <br />� �7�1�{3 <br />City of Everett Business License Number (required) <br />� �f 3 � <br />Contract Price of Wark <br />Contact Person/Contact Number/Email <br />P�(S � � c�e�l c��.�,�.`� <br />f 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 thrs type of work will be completed <br />whether specified herein or not. The granfing of a permit does not presume to give aufhority to <br />vio/afe or cance/ the provisions of any other state or local law regulating construction or the <br />performance of truction. That 1 am authorized by the owner of this property to perform the <br />work for which pplr ation is made and I comply with tate Contractors Law 18.27 RCW and <br />296.200 WA . „ �� <br />REVISEO 08/06/2014 <br />FEE <br />I � l� <br />l <br />PERMIT# <br />E�lS�C��— . <br />