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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 /> i52-3 ST ,= 3-17- 13 3 <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> � ' q?,-;–NU / YII Cr���F5 -38 <br /> l <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> f-�>aT515*9 90 zv&d 4z"j Gs <br /> State License Number I Contract Price of Work <br /> Obo i�'1��< iCdl - -x l S-�7 n q ro-nJ< <br /> Proposed Use of Building Contact Person (Plan Review) <br /> 57�. 23 <br /> Square F46otage (If residential new construction, remodel or addition) <br /> 2 <br /> Number of devices (If low voltage) 1 c n <br /> Description of Work to Be Done: n5 1 1 (�nQ Co ,3 iqn ►�✓ iyku , <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> l hereby certify that l 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/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 /> 296.200 WAC. <br /> ZT"' L— I cz <br /> Signature Date <br />