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� <br />ELECT ICAL 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 />�� � �� �� �� l� ���- <br />PROJECT ADDRESS <br />Owner `� <br />Mail Address <br />.S �-r �7 �-e �.`- i'i�" �i��2�',e'� <br />City <br />State/Zip <br />�,^i�"' S� ? Q a <br />Phone <br />s�� �� j�� <br />Tenant Mail Address City State/Zip Phone <br />s� �� <br />Electrical Contractor Mail Address <br />/�1� ��.�.nt� �� 5�,�,�� <br />State License Number (required) <br />�� � ��- �� <br />.�.,�,.,:-�.r-- , ,�=�; � � z <br />Proposed Use of Building V <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />City <br />State/Zip <br />Phone <br />City of Everett Business License Number (required) <br />����, � �-� <br />Contract Price of Work <br />l/ � .E/��a-�l/c-t�,y�, �Z � 23�)' l���C <br />,�� � <br />Contact Person/Contact Nu'mber/Email <br />� <br />� <br />/J� v <br />.'`'y�m, `-����,i�� /d�� �f�-✓���,��� , �/�� --� Ci� ��r, r� <br />, <br />�%%'� .s <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify thaf ! 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. Thaf 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 Confractors Law 18.27 RCW and <br />REVISED 08/06/2014 <br />�� <br />FEE <br />� � �j � �i <br />PERMIT# <br />E (� �-�`�:� <br />