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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT S�RVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />:���Y �� �� i�v= <br />PROJECT ADDRESS <br />� vr� � �-�> �.�,t �1� r �; L � �� <br />Ownef Mail Address City State/Zip Phone <br />Tenant <br />Mail Address <br />C ity <br />State/Zip <br />Phone <br />j�l `�(���J �� �-j.c=� � R� ��� � N � 3�-� � 5:�r-1 �R� 5� 1=-�:�• ��- 'i`�� I`�^ �'—`,—=''"�� <br />Electrical Contractor Mail Address City State/Zip Phone <br />j��.�c�li=�.C�� �NJ c�3��`t� <br />State License Number (required) City of Everett Business License Number (required) <br />� <br />Sr� ?:� �� <br />Proposed Use of Building Contract Price of Work <br />2 C^ � � <br />Square Footage (if residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: �— <br />( — r-�f��us� F�(�t �iV ff�F <br />l - 2�c�c�v<= Rts,,.��� �. i-c� <br />�G�L C � cLC�S.I� <br />Contact Person/Contact Number/Email <br />' �'�c.,;�-c�`� ( f3 AS � ��-t ��t� f <br />�- sw�Z.� t�u�. �t�N L���� FG.�o� <br />2c.��� .3 - SMe,(cr c��� l-.S�t <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <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 complefed <br />whefher specified herein or not. The granting of a permit does not presume to grve authority to <br />violaie or cancel the provisions of any other state or local law regulating construcfion or the <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />2"�—/ <br />ate <br />REVISED 08/O6/2014 <br />��� <br />FEE <br />�, �, p 0 <br />�. � L? <br />PERMIT# <br />E 1� I (�D�, �� ��o ( <br />