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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 />l.Sl� l,v . �`�� �1v <br />PROJECT ADDRESS <br />Owner <br />�- � -�- � <br />Tenant <br />Mail Address <br />C=. G( � f V�E?� ✓�t KL <br />Mail Y� ddress <br />� i� ' e c- f� � � 7�L � � <br />lectri al Contractor Mail Address <br />���3�-/����o �» �3 �v <br />State License Number <br />�-�' , <br />City <br />City <br />w���, <br />City <br />/ r��. � �.a ��-�,�, <<, ( <br />Propose .Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: �//Y�V , <br />�✓� iN�r� � t D�-5 � <br />State/Zip <br />State/Zip <br />;� �8 �o / <br />State/Zip <br />��z oo ,� <br />Contract rice of Work <br />Contact Person (Plan Review) <br />�? ��l r i« �.��.j� � <br />Phone <br />Phone <br />Phone <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 E/�� �'� <br />/-� � <br />1 hereby certify that 1 have read and examined this application and know the same to be true and <br />correcf. 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 construcfion or the <br />performance of construction. That I am authorized by ihe owner of this property fo perform the E ��,(�� �_ ��s <br />work for which applicafion is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 W/�C. ,/ <br />ig <br />REVISED 3/20/13 <br />