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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 />�/%� _� � Ri� �V� <br />PROJECT ADDRESS <br />`�'�' `�; _-� <br />5�.�=� ��f��� r� s t 3�, 7 �-c c�� c�� ��� ��r�+�v c;� � 9���-� <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />��v«:��� <br />Electrical Contractor <br />Mail Address <br />c���,�.�c: co rt�L <br />l�ICG������.0�3�'� <br />State License Number (required) <br />�z�5 �u ,��=-� <br />Proposed Use of Building <br />Mail Address <br />City <br />4_:1 �� 9 � <br />City <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />� J� � ���.i <br />City of Everett Business License Number (required) <br />�d�i�� c�= <br />Contract Price of Work <br />s �o `��',. <br />Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br />Number of devices (If low voltage) <br />� ���,�� � er� � j���1 �S <br />Description of Work to Be Done: � i 5 F�`'� � � -S � a J� [�� ���'� h ��;� I� <br />/ <br />c��t��' u�� ti n.c � Rc� � r�. ��r r�, s� s�—�D r�.�, r�-r'�t1-�c: �. ��` ��Sr�� ���c� <br />�c � E� i=( ���.�T— c..t t�� � c �v � �t S A� � c_ �i�..� . <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 `� � <br />�f ��� � � <br />1 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 completed <br />whefher specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this property to perform the E�� D ll� -�' l��� <br />work for which application is made and I comply with the State Contracfors Law 18.27 RCW and <br />296.200 WAC. <br />re <br />REVI SED 08/06/2014 <br />