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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 /> PROJECT ADDRESS <br /> (�fCAJ <br /> Owner I Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> N, Lu4 xt IJ �lf!�. ✓{ , t C��� �d <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> P/1 '0 61 E <br /> State License Number Contract Price of Work <br /> S YK <br /> Proposed Use of Building Contact Person (Plan Review) <br /> L-I j <br /> Square Footage (If residential new construction, remodel or addition) <br /> Numb-vices (If low voltage) <br /> Description of Work to Be Done: 1 G QI Ca <br /> FEE <br /> �U <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <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 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 '1'405-- <br /> work <br /> ,I y-05 work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. � <br /> 7 J <br /> Signature ate <br />