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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.arg <br /> PROJECT ADDRESS <br /> vol• -,JA a-_c_I <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Q:dA a . q 6 0) 5 L- ,Sea iA� <,-o. q X81 X018 a 6 --jA o <br /> Electrical Contractor Mail Address City statel2ip Phone <br /> Dooa Q,a 3 o <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of work <br /> ,1124ml-f- JaID flc�' <br /> Square Footage(If residential new construction, remodel or addition) Contact Perso /Contact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: r A CSC. <br /> Q <br /> C-1 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE lS 3105 ( JOro <br /> I hereby certify that I have read and examined this application and know the same to be true and v <br /> correct. All provisions oflaws 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/am aulhorizod by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18,27 RCW and <br /> 1 .204 WAC, <br /> $ign�tiarn Dtit� <br /> RF,VISF0 fN M7,0TA <br />