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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 />�3�� <br />PROJECT ADDRESS <br />�G C� ti � <br />Owner <br />Tenant <br />/Vr� S S �� �( <br />,. � � `i�""�=- ��� <br />Mail Address <br />Mail Address <br />.�� �� I � � �t�-� D� �L�C��IC, <br />Electrical Contractor Mail Address <br />.lJL �� /— i Uc�v (�C <br />State License Number <br />� � � <br />Proposed Use of Building <br />City <br />City <br />1� � <br />City <br />S�� �: � <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: "`� ��� /�� `"-J �� �` s� <br />State/Zip <br />State/Zip <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 C,j � C,e� <br />l hereby certify that I have read and examined this application and know the same to be true and l <br />correct. All provisions of laws and ordinances governing this type of work wil! be completed <br />whether specified herein or not. The granting of a permit does not presume to give authoriiy 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 aufhorized by the owner of this property to pertorm the E��� ( C-_ ��� <br />work for which application is made and ! comply with the Stafe Contractors Law 18.27 RCW and <br />296.2 WAC. <br />� <br />, �;�.,� �� -- �o - �` � _ i 3 <br />ure <br />REVfSED 3/20/13 <br />Phone <br />Phone <br />Phone <br />