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� <br />EL�CiRICAL PER�llli �4��LICA�I�N <br />CITY OF EVERETT PERi�ili SE�iiiCE� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� I � � ��� � J -I r) L ( -l- C_ }� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Electrical Contractor <br />Mail Address <br />Mail Address <br />Mail Address <br />�.J�I�EL �"L ��n/ <br />Stale License Number <br />Proposed 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: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />City <br />City <br />State/Zip <br />State2ip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />l hereby certify that l bave read and examined this application and know the same to be true and <br />correcf All provisions of laws and ordinances goveming fhis type of wo�k will be completed <br />whether specifred herein or not. The granting of a permit does not presume to give authorify to <br />violate or cancel the provisions of any othe� stafe orloca! law regulating construction or fhe <br />performance of construction. That! am authorized by fhe owner of fhis prope�ty fo perform the <br />work for which applrcafion is made and ! comply with fhe State Contractors Law 18.27 RCW and <br />296.200 WA��VJ�� ,� h.�..... �._. <br />2� � <br />fi <br />va <br />�Z�7� � <br />Phone <br />Phone <br />��' '� <br />Phone <br />FEE <br />� C,�� <br />`J � <br />PERMIT# <br />E I �-o=� - 13 � <br />