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Alb, Is <br /> 1W IMF <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 /> --71 Z r <br /> PROJECT ADDRESS <br /> OwnerMail Addrds City P State/Zip Phone <br /> ' <br /> Tenant Mail Addrd City State/Zip Phone C <br /> yZS 7 -? <br /> Electrical Contractor Mail Address City tate/Zip Phone <br /> State License Number Contract Price of Work <br /> �'; l-/Ham,s <br /> sin �:1 A <br /> Proposed Use <br /> YofB uiilldiing Contact Person (Plan Review) <br /> 5�� P <br /> Square Footage (If rel sidential new construction, remodel or addition) <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: /U <br /> ZC <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> l 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 f1 <br /> performance of construction. That 1 am authorized by the owner of this property to perform the V V 1 3 1 I — Vv e <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> u re Date <br /> REVISED 3/20/13 <br />