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• <br />• <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 />3� i I�Yr�..�ii, ,x�.�, ,�E��re�-1- `� b'�? 01 <br />PROJECT ADDRESS <br />m <br />Tenant <br />I Address <br />t� <br />Mail Address <br />[� <br />City <br />State/Zip <br />l� <br />State/Zip <br />i `f ' `� toCo 7 <br />Phone <br />� <br />Phone <br />j - L �- i i !� ' jiu; . �� —� <br />ElectriCal ContraCtor Mail Address State/Zip Phone <br />��'�a ��`� � 7Z177 �`%`"r 1�`��� <br />State License Number (required) City of Everett Business License Number (required) <br />, <br />� �. � j.! 1� G'� L� �i <br />��( <br />Proposed Use of Building Contract Price of Work <br />Square Footage (If residential new construction, remodei or addition) <br />Number of devices (If low voltage) <br />��Sb, M�ll�r, 3t�;� 3�)3--�2�5 <br />Contact Person/Contact Number/Email <br />� uS1��.' W C'S}�+ n"jCl Ur` i� . C u►'i'� <br />Description of Work to Be Done: 1��•�-�� j���-���"Ya �r� �� �� ��lC✓ P� Si�`'�7'� Q�. rC�(�" <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <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 will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />vrolate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which appli ation is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.20 WA . <br />'� I�� d/� �f 2lS 2Gf S <br />REVISED <br />FEE <br />� I� °° <br />1� <br />PERMIT# <br />E ��� r CO l l.� <br />