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0 • <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 /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> zG A, y�Z7) 0z� �o�- 75 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 1-u( <br /> State License Number C ntract Price of Work <br /> l�'-t' <br /> Proposed Use of Building Contact Person (Plan Review) <br /> T,cJ <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 /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 0� <br /> I hereby certify that l have read and examined this application and know the same 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 to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the ( � <br /> performance of construction. That I am authorized by the owner of this property to perform the `'d <br /> work for which application is and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Date <br />