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- y FAQ per( i t <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 4,25-257-8857 –www.everettwa.org <br /> 200 <br /> PROJECT ADDRESS <br /> Owner Mail Address City StateiLlp Phone <br /> o, A)..D PO �c�c I Io'? Eqn, it WA 28MG yes-�83-:ssi.Y <br /> Tenant Mail Address City State/'Lip PYione <br /> btu Uli'i5r11 �V Ste- 201, <br /> X1'1 S&c,0P--rff eUt �uE7,1 l00 „tvoo. W,A 9'9 0 5-1 Lt-?>553 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> ARoiis5G o I -�,c G,. 0 -29 V 5 <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <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 /> i -rA,— c-ou a SEA 132 <br /> FEE (�(� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 310513 U <br /> `-J <br /> i hereby certify that I have read and examined this application and know the sarne to be true and <br /> correct, 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 10 PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the r I �� I I -7 <br /> perforrnance of construction. That I am authorized by the owner of this property to perform the t <br /> work for which application is rnade and I comply with the State Contractors Law 18,27 RCW and <br /> 296.2 WA C, <br /> Signature Date <br /> �'ta�;L.t5i� � %Ale©rss�t� VAx <br /> REVISED 3120/73 _ <br /> J <br /> Ta/TB 39Vd JSV 9TLLb8Z90Z 9Z:9T t1TBZ/t1Z/69 <br />