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Ask <br /> 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.gov <br /> � 0 \01 k 9*` pu'c s <br /> PROJECT ADDRESS <br /> L <br /> Owned Mail Address City State/Zip Phone <br /> 2 <br /> Tenant Mail Address City State/Zip Phone <br /> -3 (oo <br /> 'R4,5 -3 leer, `� I�l IZ Vti�tl�y t�(� l✓c7A2?T G <br /> Electrical Contractor Mail Address ciiy State/Zip Phone <br /> 'R<,- C' La * * o2Z Q o3 `jVSS <br /> State License Number(required) City of Everett Business License Number(required) <br /> Fye C-rlt, A i (�' , 66-5 - °© <br /> Proposed Use of Building Contract Price of Work <br /> 47,5 -Z6-S - 20 13 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) r <br /> Description of Work to Be Done: - ►�/2)mA,I 1�"�5�rt250c -6 <br /> 4 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ?�5 C`�J <br /> l hereby certify that/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 1 am authorized by the owner of this property to perform the E I <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Date <br /> REVISED 08/06/2014 <br />