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Nov. 30- 2015 4: 12PM No, 1033 P. 3 <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 /> ;-4. • 7 <br /> Owner r Mail Addrt-F,--. city State/Zip Phone <br /> Tenant Mail Addiess Cily Phone <br /> .(-i (iJk-,J4 <br /> ok. Qe'� 6' U <br /> Electrical Contractor Mail Address City Statelzip Phone <br /> Stale License Number(required) City of Everett Business License Number(reqLlit-cicl) <br /> VA &I <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(if residential now construction,remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low volta'g-e) <br /> Description of Work to Be Done: <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 4 <br /> I hereby certify Mal I ha vo mod and examined tris applioation and know the same lobe true and <br /> correct. All provisions of laws and ordinances governing this type of work will be Completed <br /> whrthar specified herein or not. Tbe granting of permit does not presume to give auffiority to PERMIT# <br /> violate or*cancol the"provisions of any other stato or local law regulating construction or the <br /> performance ofcot)sti,iictioti, That lam authorized by the owner-of this property to perform the E <br /> work for which application is made and I CO/?7p/y with the State Contractors I aw 93.27 RCW and <br /> 296,200 WA <br /> Date' <br /> r?EV1SE00W01,V.1r)j4 <br />