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• 0 <br /> ELECTRICAL PER9 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�i�C� ►3�'� S� FyLr'L�-�- L�J�t `�i��'-� t <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> Y C ECS 512 � oc'Lf!q- <br /> -State License Number(required) City of Everett Business License Number(required) <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:/1cLJ�cvt �' "AAS Lc�: � �l C1= I��uS� .Jtn � <br /> l:�G �04 n �'�l Z�L '� �� NL4 '-'CW1G' cjc---ke"X �ru"A QX 7�.n� IOCXLS Cr 7 <br /> i1CA J ( bC i�w-1CrJ �r G� FL►tC.' ��AL I Z o \GCC ikC.- "CC..K <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 $ <br /> 1 hereby certify that 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 give authority to PERMIT# <br /> violate or cancel the provisions of any other state orlocal law regulating construction or the El U )^(v' <br /> performance of construction. That lam authorized by the owner of this property to perform the � <br /> work for which application is made and l comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Dale <br /> REVISED 08/06/2014 <br />