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—I_. 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 /> L S F. <br /> PROJECT ADDRESS <br /> L47 5- 3H�— <br /> C� °r <br /> Owner Mail Addre s City State/Zip Phone <br /> Tenant Mail Address ,y City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 91.1 47 6S 'b-() P��L g(DKS— <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email �+ <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: {—C. A. <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ' <br /> /hereby certify that/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 I I � <br /> performance of construction. That/am authorized by the owner of this property to perform the <br /> work for which application is made and/comply with the State Contractors Law 18.27 RCW and <br /> 296.;�/� <br /> Signature Date <br /> REVISED 010612014 <br />