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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 /> PROJECT ADDRESS <br /> 1rtv'd"«.L L-yuci'-� <br /> Owner Mail Address City State/Zip Phone <br /> 3 ` S} Eycr-c44- 11— Of) <br /> Tenant Mail Address City State/Zip Phone <br /> fb Fm M40- &CAC <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> cfig4r,L45 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Has X41 $'(Do <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: Ly ex;tx, n< C'rC� A, 4 t vx <br /> , <br /> st&crwcil &joyc' �1—�^�� bpi(" i p� F1—tt.i V'i 1V LI f Ckt-4 <br /> T T— <br /> dcc f Po"4.3es' SuAA 1%c.S ley CA e�-W�yk <br /> FEE <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 PERMIT# <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 E 1502- _ 09 U <br /> work for which application is made and l comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. On <br /> Signa re Date <br /> REVISED 08/06/2014 <br />