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• <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 /> PROJECT ADDRESS <br /> - 't5 <br /> Owner Mail Address <br /> City Slate/Zip Phone <br /> Tenant Mail Address City StatelZip Phone <br /> Lwrta�t La-Z 1116 y 0 f <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 9 Dooa 1;2>a 3 0 <br /> State License Number(required) City of Everett Business License Number(required) <br /> SIC- <br /> Proposed Use of Building Contract Price of Work <br /> 38 "A- �tw o bb '- ofgB qq6b <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) ii i <br /> Descriptio of Work to Be Done: ! r r cmc{ - -�(�1 c_-art Cl e- 'I r e J � -� b 1z' <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � I J <br /> I hereby certify that i have road 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 glue authority to PERMIT* <br /> violate or cancel the provisions of any other state or/coal law regulating construction or the <br /> performance of construction. That/am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 200 WA C. <br /> Signature Date <br /> REVISED 0..207Q <br />