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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.gov <br />—� ��,� �� �ver�T�t �Jc, ��� <br />PF�OJECT ADDRESS <br />Owner <br />Tenant <br />���C7`r17Yll r� /,,�� <br />Electrical Contractor <br />Mail Address <br />� r� ^ <br />ail Address <br />�i�fi%I �� :S, � <br />� Mail Address <br />��Fc� ������r <br />State License Number (required) <br />roposed Use of Building <br />City <br />City <br />C'J� : o <br />City <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 />� <br />� <br />State/Zip <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />�U�} <br />��6 .� `� �� <br />Phone <br />� �� � �� � --�. 7/ ���s <br />City of Everett Business License Number (required) <br />�� ��� _, <br />Contract Price of Work <br />i �� f h� 6� ��vC - yoB =� � y� <br />Contact Person/Contact Number/Email <br />L' C�S r� L' �(' ���i"L�r3. L"Gi"'! <br />�c <br />1 hereby certify that 1 have read and examined this application and know the same to be true and <br />co��rect. AII provisions of laws and ordinances goveming this type of wo►1c will be complefed <br />wh�ether specified herein or not. 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 construction or the <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which application is made and I comp/y with the State Contractors Law 18.27 RCW and <br />296.200 WA� / �"� <br />ry <br />�!G <br />REI/ISED 08/O6/2014 <br />FEE <br />��ov <br />PERMIT# <br />E� i 50�7 -D�g <br />