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� <br />ELECi'i�ICi4�. PERMIT' APPLOCATIOfV <br />,;. <br /><_� J � � <br />, <br />PROJECT ADDRESS <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 />�� �-L s-�-� <br />�� ' <br />� d-y ,i �� �.- /� <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />City <br />City <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />, <br />�'r / .-i a r� '�-� <br />/2� n y-7 /"�/` /1 /� / � ! � .�. /+" c _ �i'7 <' ��.f 1 � " !%,j.� 7 'C.� �L.,� �/�,' �././� / 2�� a''.� <br />Electrical Contractor Mail Address Ciry State/Zip Phone <br />�✓� >' T�-% 1 Z' o r/<<' /�/2 <br />State License Number (required) <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />��a�� �� <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: J�c-.v c�� �-c; ''��.�*.—�`-- <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the same to be frue and <br />correct. AlI provisions of laws and ordinances goveming 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 <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 <br />work for which application is made and I comply with the Stafe Contractors Law 98.27 RCW and <br />296.200 WAC. <br />�� <br />re <br />FEE <br />(i � <br />.���� -/ <br />PERMIT# <br />E i �b� - �� (� <br />