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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 />��� � � � 7"�L � t� � = C� �� t� � �� � ?�� i <br />PROJECT ADDRESS <br />�G� � � �i =�t; :�,;� A " '�'"� �j r ;' G�� r�(� <br />Owne� Mail Address <br />City <br />State/Zip Phone <br />Ten�nt Mail Address City State/Zip Phone <br />�S � � �{ - � 3� �� (� t�j � .,/� �-z� <br />� � � � C`C � '— l� ✓ L V � " ' v��0.� � � l� �i� L VC i� (�� L f/"f �� ! G'A,^K' �l r ll � '—�7 / <br />EleCtriCal ContrBCtor Mail Address City State/Zip Phone <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 />r <br />Description of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�-� <br />i^, � G��`�� <br />City of Everet� Business License Number (required) <br />� �`�� i ��z- �u <br />� <br />Contract Price of Work <br />���- ' <br />Contact Person/Contact NumberlEmail <br />I hereby certify that 1 have read and examined this app/ication and know the same to be true and <br />correct. All provisions of laws and ordinances governrng this type of work wil/ be completed <br />whether specified herein or not. The granting of a permit does not presume to give aufhority to <br />violate or cancel the provisions of any other sfate or local law regulating construction or the <br />performance of construction. That 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 18.27 RCW and <br />296.200 WAC. 7 <br />� , �,. <br />' Z�'� i 2��� �d � <br />FEE <br />� C� ��} <br />i '--� <br />PERMIT# <br />E (L7 ( �, � ��( <br />