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• 0 <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.org <br /> 916 7 L9' Or s E <br /> PROJECT ADDRESS <br /> F5Tat,- JgyrilGy+ FL/er,-, ft" <br /> Owner Mail Address /� City State/Zip Phone <br /> Ocl" P" 5L I ve✓eT f `�c�� 'J `f ZS L� fljj <br /> Tenant Mail Address City State/Zip Phone <br /> 0VVn��' <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> ,r(�o <br /> State License Number Contract Price of Work <br /> I 1 to f, ,>>, I4 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> � c <br /> Square Footage(If residential new con struction,(�emode er addition) <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: rl �)10 i s m v Xe L`,Tif i In h G d I <br /> �elocate li' ►45WJ'k CeloTdc.fe . i-, eyFe- <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105j-0 G <br /> /hereby certify that I have read and examined this application and know the same to be true and J <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 1 1 ©� y <br /> performance of construction. That I am authorized by the owner of this property to perform the L.� <br /> work for which application is made and/comply with the State Contractors Law 98.27 RCW and <br /> 296.200 WAC. <br /> I, ,J, 4 2,01� <br /> ig ure I Date <br />