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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 />� C�C�1 � �`�G� �1.� � <br />PROJECT ADDRESS <br />�l�� <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />1. �1�e��\ e:v u� <br />City <br />City <br />q�� ��� -�G� <br />,2i� Phone <br />State2ip <br />Phone <br />Q%��, C,�� �:.e. �C�C`) 12� ��' �ve. �lJC, �\�evL�P l,�i� ���'"J � �Gq <br />Electrical Contractor Mail Address City State2ip Phone <br />O���G��a�u�•� <br />State License Number <br />Proposed Use of Building <br />Square Footage (If residential new constntction, remodel or addition) <br />Number of devices (If low voltage) <br />a <br />Contract Price of Work <br />�"Xe�'� 1� � mcn�c�.zhe�.�m <br />Contact Person (Plan Review) <br />Description of Work to Be Done: d� � 8C�'f� i1c'�(1� S'�i;�aC� � Cn :il� , L��G 8�� � <br />��'1t�C.� �..�,C'C� ii��.� � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 31D5 <br />I hereby certify ihat 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances goveming fhis fype of woric wi!! be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any ofher sfate or local !aw regulating construction or the <br />performance of construction. Thaf 1 am authorized by the owner of this property to perform ihe <br />woric for which application is made and J comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Reviseo snar3 <br />FEE <br />�� � <br />� <br />PERMIT# <br />E ��o � �-�`�� <br />