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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 /> YL 7 � t� i ' <br /> PROJECT ADDRESS <br /> 12 <br /> Owner Mail Address City State/Zip Phone <br /> ant Mail Address City State/Zip Phone <br /> 0qn, C- XC-713-k X( YF-7�,-e� <br /> Ele ntractor Mail Address City State/Zip Phone <br /> State License Number iCact Price of Work <br /> rn�tt <br /> t <br /> PropdsUse of Building Contact Person (Plan Review) <br /> l �0 <br /> Square Fbotage (If residenal new construction, remodel or addition) <br /> Number of devices (If low voltage) <br /> Description of Wo r to Be Done: > 6 �.1 �'L d� <br /> 19 <br /> o 7 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 l� I <br /> /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 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 I am authorized by the owner of this property to perform the E l <br /> work f is plication is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296. 00 WAC. �A <br /> 1 <br /> ignature Date <br /> REVISED 3/20/13 <br />