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• s <br /> ............ <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 /> W8 <br /> PROJECT ADDRESS <br /> 7te s'30 tvsE vew'ctt m ti�' 2t)& -m4�' <br /> Owner Mail Address City Stateizip Phone <br /> Tenant Mail Address City State/Zip (L4 <br /> 11A <br /> q cml� J 0 I's <br /> lectrical Contractor Mail Address <br /> City State/Zip phoin <br /> i <br /> 9 41a <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building of Work <br /> y <br /> Square Footage(If residential new construction. remodel or addition) Contact Person/Contact Number/Email <br /> Call <br /> i Number of devices(if low voltage) <br /> � - t f I Description of Work to Be Done Ck LY <br /> I FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br /> I 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 goveming this type of work will be completed <br /> whether specified herein or not. The granting of permit does not pieSLItne to give authority to PERMIT# <br /> 1 violate or cancel the provisions of any other state or local law regulating construction or the <br /> 1- <br /> performance of construction. That I am authorized by the owner of this property to perforrF7 the E1j <br /> work for which application is made and l comply with the State Contractors Law 18 27 RCW and <br /> 296.200 WAC <br /> REVISED 061OW014 <br />