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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 />� 1� ���'� �� �,�� i�� <br />a <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />��� C�h ,� K 1��2s=i� �7 (� -`[ r <br />Mail Address <br />� ` iJ � �� iZU /� � <br />Maii Address <br />City <br />City <br />State/Zip <br />�'� �Z�; ?7 Ir.l�� <br />State/Zip <br />Phane <br />�"'2 0 � <br />Phone <br />s�w� s�����,��2� s��U�� �� 12yJ,� IZ�9y� ��t R�� �v�-�w,� 9�'� <br />Electrical Contractor Mail Address City StatelZi Phone <br />�� �� �y5,�s <br />So��- d ss �76 T�j ���' <br />State License Number Contract Price of Work <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />.? -- <br />Number of devices (If low voltage) <br />Contact Person (Plan Review) <br />Description of Work to Be Done: (.�:�� � ��`�'e� � �/'G�� �� G �`�DY� <br />%ry�, /�i3C,�.lC jr� LU��c /+.-..�7 ICC�� %�p <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 31D5 <br />1 hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances goveming this type of work wiU be completed <br />whether specified herein or not. The granting of a permif does not presume to give authority to <br />violate or cancei the provisions of any other state or local law regulating constn�ction or the <br />performance of construction. That 1 am authorized by the owner of this property to perfonn the <br />worlc for which application is made and 1 comply with the Siate Contractors Law 18.27 RCW and <br />296.200 WAC. <br />� �� � ���� � <br />REVISED 320/13 <br />FEE <br />� � - � ,,�r <br />PERMIT# <br />E � �G �� , � <br />