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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 />`i � 'za 1 <br />1 t� �'� Vi�'� ih i �i ,q i.'�z � V�e re�l. �r✓� . <br />PROJECT ADDRESS <br />� ��-��y ���y <br />��a,�U��,� �U�Q�-i �ei/OC�iblk���ii^��►�l'�S� f��l� �����V'e (rJ ��hn�/OC�C� � l/l�/`l �(��0.3� <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />(� w'YL�Y <br />Electrical Contractor <br />State License Number <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />l J� <br />Square Footage (If residential new construction, remodel or addition) <br />;,✓� il �, ��, t�r <br />Number of devices (If low voltage) <br />City <br />City <br />State/Zip <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: C'!�� �. �i��le fs �r � w'�� l`�'S r) ni'�� l�ip_Gl�/f�'� Ct �,%�nYd <br />—� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify thaf 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 grve 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 pertorm 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 />� ��; <br />re <br />REVISED 3/20/13 <br />�-��l-�y <br />FEE <br />�li�� o� <br />PERMIT# <br />E ����� ��� <br />Phone <br />Phone <br />