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• <br />ELECTRICAL <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 />� � d Z Q� ck.r.e,�' �c�,-e� <br />PROJECT ADDRESS <br />1� � , <br />Owner <br />� <br />Tenant <br />� <br />Electrical Contractor <br />c'�E���C0�7�LS <br />State License Number <br />,!- "'�(/�.�`' <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />Mail Address <br />Square Footage (If residential new construction, remodel or addition) <br />� � �l qi"I(�?g <br />Number of device If low voltage) <br />Description of Work to Be Done: <br />� �I 1 �iarv�S <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />City <br />City <br />State/Zip <br />State/Zip <br />State/Zip q <br />L <br />� <br />Contract Price of Work <br />�(�iC-G�: -�s.�.i�/ <br />Contact Person (Plan Review) <br />f hereby certify that I have read and examined this application and know the same to be true and <br />correct. AI! 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 to <br />violate or cancel ti�e provisions of any other state or Iocal !aw regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perfonn the <br />work for which application is made and I comply witl� the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />REVISED 3/20/13 <br />Phone <br />Phone <br />FEE <br />� �' <br />PERMIT# <br />E��-o�-IZ� <br />