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• <br />�� <br />EL�CiRIC�4L PERnllli A�PLIC�►�I��➢ <br />CITl� O�' EVE��Ti PERi�ili SE�iiiC�� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />` �'� C� h e-s-+-►� �,�.-� C �-- <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Electricai Contractor <br />Mail Address <br />Mail Address <br />�.�i � EL �� � (�l�'!1�l <br />Stale License Number <br />Proposed Use of Building <br />il Address <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />City <br />City <br />StatelZip <br />State2ip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />1 hereby cerfify that 1 have read and examined thrs application and know the same fo 6e true and <br />correct. All provisions of laws and ordinances goveming fhis type of work will be completed <br />whether speciFed herein or not Tl�e granting of a permit does not presume to give authority to <br />violate or cance! the provisions of any other stafe or local faw regulating construcfion or ihe <br />performance of construction. Tl�af I am aufhorized by the owner of fhis properfy to perform the <br />work for whiclt application is made and I comply with the Sfate Contracfors Law 18.27 RCW and <br />296.200 WAC, <br />� __ <br />�n�fi ira <br />G�1-�--/ � � <br />Phone <br />Phone <br />��' 1� <br />Phone <br />FEE <br />��. D � <br />PERMIT# <br />E��������� <br />