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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.org <br /> ,L -6111'6� � 7 :?C) <br /> tx'// <br /> PROJECT ADDRESS <br /> If t <br /> (*yj y (��'�� Il C5 �ve <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> ft(,L 1(v rNOt5-71c�L 0 5..-L 7 75 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/ ontact Number/Email <br /> Number of devices (If low voltage) J <br /> Description of Work to Be Done: �GtiZ� i ( ci!'�G(. C'" e Cf <br /> f / II <br /> FEE 0� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I 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 orcancel the provisions of any other state orlocal law regulating construction or the /�p <br /> performance of construction. That I am authorized by the owner of this property to perform the E <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 AC. <br /> 7-1 <br /> Sign re Date <br /> REVISED 0/06/2014 <br />