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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 />�- � / %' � �� � � � �— <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />p �s �i i��� ,�''� i �'�-� I L, t=f 1g' �� <br />Mail Address <br />Mail Address <br />City <br />C ity <br />y� <br />State/Zip <br />State/Zip <br />�, / G � �"i � 4� � <br />Phone <br />Phone <br />/���� �L� i � � i �/ ,�C� r= �- � i `i � �.` � / �` � � �'��/ � �/-��: �2 j j 1 i`i/ i�� � `; '' �'� <br />Electrical Contractor Mail Address City State/Zip _ Phone <br />�f a :� 3 � �� -L `l�: `-# � <br />/� �-- L= ( �,�" � �.- G � � 1`�.� .J <br />State License Number (required) <br />� F— % <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />J3� ���� <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: f � %" ru..� / �Z-[ = /�X :1 i � ( ! r�._.�i �� f � � t ' � /`f ��� <br />d�i� �' _ r'—vp /�'/`-( (� G-vf�-/7 �C? f:�f( �'=.f�� - <br />� <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 completed <br />whether specified herein or nof. 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 I am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the Stafe Contractors Law 18.27 RCW and <br />296.200 WAC. <br />/%%i <br />nature <br />REVISED 08/06/2014 <br />i _ � y -�''`, <br />Date <br />FEE <br />�� c� <br />� <br />PERMIT# <br />E ( ����—,� c� <br />