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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 />�� :� � i � 2�;t�-p � ��- <br />PROJECT ADDRESS <br />C'.l� �- C�:i��r� l �.5 3`33 i p i���v�u�� �"���,2e� <br />Owner Mail Address City <br />c��. ��Zv� <br />State/Zip Phone <br />�`�i�-C-� � i� C�-1� � � � � l��-GF� �v�4A- L�c �v ��` w� `i �5.:� c I <br />Tenant Mail Address City State/Zip Phone <br />�?�.:�C-�`rm C�C ir��, 1 q � Z�L��-i'c..�',�� t,ac�— ��UE�� L�'"� `�' ��� 1 <br />Electrical Contractor Mail Address City State/Zip Phone <br />5C-�c..����i ��ti �� <br />State License Number (required) <br />Proposed Use of Building <br />�`5 � <br />Square Footage (If residential new construction, remodel or addition) <br />�/ <br />Number of devices (If low voltage) <br />C� �r?� C� �� <br />City of Everett Business License Number (required) <br />.,� z � �� �� <br />Contract Price of Work <br />�"h� Cc:'ol %� `�"7�� - Z!9 �-Y�l� y�- <br />Contact Person/Contact Number/Email <br />l <br />Description of Work to Be Done: j-�-� �'N � ���''� �`� �� U�'V� �"� �"" G�� (2--� �--��-I� �`1 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I 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 will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />perfo►mance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. � <br />REV/SED 08/O6/2014 <br />FEE <br />�b�y�C� <br />PERMIT# <br />E ����— � � <br />