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� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMII" SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />�"�.=�5 �o� )u, �- �^� �/ �� �`�'� tik�f '�`������- � <br />PROJECT ADDRESS � <br />� <br />Tenant <br />�-si C�X�� ��f`� <br />Electrical Contractor <br />�-���.��._. �� <br />Mail Address <br />Mail Address <br />�, ������ , ` <br />�` <br />Mail Address <br />�� L�� � 5 ��7�� � <br />State License Number <br />C ity <br />State/Zip <br />Phone <br />City State/Zip Phone <br />_ `� C �7-� j�, � C`i 1 <br />_�� /` <br />�� l; ��--`�' �� �r=T�r ��t;�r`�.e� ��' � �� S, �,� � <br />�r--- <br />`� .�-�,,-,�� G�� <br />Proposed Use of Building <br />, � <br />Square Footage (If residential new construction, remodel or addition) <br />City <br />State/Zip Phone <br />�A <br />`E, � <br />Contract Price of Work <br />i <br />� e_� l f % <br />�c V��.��. � <br />Contact Person (Plan Review) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: j�U��'Y�`� `� ��J ��1 � �-('' ��,P � 3 7` ��`�` �' C�' ��- <br />� �� � <br />� ��` S -�-� t-�� ,, <�' v��J� °� � -�' � � �c � i �� ��'� 1���� �' � <br />__` <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />-- r �� i �- , �� �� �r�-�ti <br />! hereby certify that I have read and examined this application and know ihe same to be true and <br />correct. All provisions of laws and ordinances governing fhis type of work will be completed <br />whefher specified he�ein or not. The granting of a permit does not presume to give authority to <br />violafe or cance! the provisions of any othe� stafe orlocal law regulating construction or the <br />performance of construction. That I am authorized by fhe owner of fhis property fo perform the <br />work for which applrcation i and 1 comply with the State Contracfors Law 18.27 RCW and <br />296.200 WAC. � �- <br />�� � <br />ature <br />FEE <br />�l�/l <br />�OC..� <br />PERMIT# <br />E�� �� - D�� <br />