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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.gov <br /> I C� U9 tUU4" PL !I <br /> PROJECT ADDRESS S--- .33/7--31rL, <br /> S', 1ve� Lwlcc D-p-,n 41-- 4*4S r9L - SSL-" <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> � ZS3-SC41 t� <br /> �►'(���' 1 �- ZZ.�Z(o (9 ��' USS - �h,�-- l�V�- `��'U3L <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> fro'T--o 4353 f 3� y y 3 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> J-mj,'�,r <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) (,C-TV <br /> '( 1 / c n 1� <br /> Description of Work to Be Done: (,�1 V c:Ss S� kn " / G-n/tt�ci S I V V(Z— <br /> FEE rr�� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 00 <br /> I 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 rovisions of any other state or local law regulating construction or the O . <br /> performance o cons uction. That/am authorized by the owner of this property to perform thE ;e D I D <br /> work for whi4 applicb tion is made and/comply with the State Contractors Law 18.27 R C W and <br /> 296.200 WA <br /> 1 ZZ <br /> I ) <br /> Signature Date <br /> REVISED 0810612014 <br />