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ELECTRICAL PERMIT APPLICATI�N <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 />�.SZ� �j:,z %�� ` � ���. <br />PROJECT ADDRESS <br />> A v i c.� � � ;� � :� t3 �? �� �ica �; I �. 2 �" � �u c r� c.`��" w �* �'13 2G:o ��o y��y S/� l <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />Mail Address <br />C ity <br />State/Zip <br />Phone <br />SD �l �`: C I�r..i . /// a-/ �{ Z N� 5't S�" Snok�c��ti. � � t�� ��' r� l'`2::; a'.,'6,r !Z ? <br />Electrical ContraCtor' Mail Address City StatelZip Phone � <br />S�(is E1 89Z P o <br />State License Number <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />i <br />�b A- r� ;G `fi? � i0 5..�.-t , <br />Contract Price of ork <br />Contact Person (Plan Review) <br />� �� <br />Description of Work to Be Done: ;��'f t:,-; �:,��,�C.�.-�c/f r<rr:_ ,i!�- _/ ,,�-� � p:. -"C:;:.,-. ' <br />/ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I 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 <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized 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 />296.200 WAC. <br />re <br />REVISED 3/20/13 <br />uate <br />FEE <br />���j . ��� <br />PERMIT# <br />E I �.�G��-��( <br />