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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 /> Owner Mail Address City State/Zip Phone <br /> TenantMail Address City State/Zip Phone <br /> n yzs=73 7- <br /> -773 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number Contract Price of Work, <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage (If residential new construction, remodel or addition) <br /> Number of devices (If low voltage) / <br /> Description of Work to Be Done: � l__�l ���/ ' I � C <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that l have read and examined this application and know the same to be true and �6( ✓� <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 �� 0,/� <br /> performance of construction. That I am authorized by the owner of this property to perform the E o/ <br /> work for which application is made and l comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> j ry <br /> Signature Date <br /> REVISED 3120/13 <br />