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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 />. -�� �� ��.���..� ��„��� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />,j� /� � r-I <br />�� '7X k� � �` �'f LJh � <br />k, <br />Electrical Contractor Mail Address <br />��� �\� ��� v `�� <br />State License Number <br />\ t` <br />Proposed se of Building <br />�� l � i ��.�c��Q <br />City <br />City <br />s�S� � �C.-�f <br />City <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />D <br />State/Zip <br />State/Zip <br />StatelZip <br />��C� KJ� <br />Contract Price of Work <br />' Phone <br />Phone <br />G�Z �Iz�� >'��7�� <br />Phone <br />C-�,n�g.�tf <br />Contact Person (Plan Review) <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 wo�k will be completed <br />whetherspecified herein ornot. 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 construcfion or the <br />performance of construction. That I am authorized by the owner of this property to perform fhe <br />work for which applicafion is made and l comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Sign <br />REVISED 3/20/13 <br />�� I�L I � � <br />Date <br />FEE <br />..��� c� <br />PERMIT# <br />E �� l��C' 7"�=' C' � <br />( <br />