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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 />�00( <br />�� f , <br />�- � c. � �;�" � � ���� <br />, <br />PROJECT ADDRESS <br />J �) / <br />('� � ^� L � ' '� /X ��� /� ��� % i �- f, . �.- -�` '' 1r <br />�I�C �Z/)I-�J� ��-����l�1; C.'L /`��4!t J'�L1�s; � /c �� �- �t ,� � <br />J <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />Mail Address <br />City <br />State/Zip <br />Phone <br />i?���,��,����dl�' �r, >c'��.5- -;��1��i�f� � `�,r; �r� �, �f�����r���°�U� ��i( <br />Electrical Contractor Mail Address City State/Zip Phone <br />�")��.�� /,�(���/� ���� <br />State License Number <br />`_ .�_`> � � -t � ` <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />7� L/t ���� � -_ <br />i lc <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: �.�5 � E,� U��r l�? :.� ��� J C� l�d ���'�� 1� l / r-� { !� " %. . i <br />. �t l .�'� �> C � F<: r �� �, - L �K� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 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 fo <br />violate or cancel the provisions of any other state or loca! 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 />r / / <br />;'�+ / ��� �' � J�:�,� _ ��l` t�c �;.� �� ��` -� ��� ^( �� <br />Date <br />REVISED 3/20/13 <br />FEE <br />�`��-Sa <br />PERMIT# <br />E�3c0--�3� <br />