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� <br />� <br />ELECTRIC/-��L PERMIT APPLICA`TIOiV <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 �1� � lS��i ��� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />z�t � rs� <br />Mail Address <br />Mail Address <br />City <br />City <br />State/Zip <br />StatelZip <br />; .��b ,�2SS�C�1�f <br />Phone <br />Phone <br />���,t�j.=t� - r-�`�'fC �� �'�� t�`� c ��: � �- i,� ��'��l �l.�.S,7�t����2Gy <br />Electrical Contractor Mail Address City State/Zip Phone <br />/ ��'�,c-_ � 6 �--C� � � <br />State License Number (required) <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: �t:t'v u CC� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />������ <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />Contact Person/Contact Number/Email <br />1 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 goveming this type of work will be complefed <br />whether specified herein or not. The granting of a permit does nof presume to give authority to <br />violafe 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 Contractors Law 98.27 RCW and <br />296.200 WAC. <br />� l� <br />FEE <br />—�� �;�..� <br />PERMIT# <br />E15C�3 - �55 <br />