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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 /> ' �i(W1 C,l <br /> PROJECT ADDRESS <br /> -,I�V)11-� � R <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> SoLAi, J J q oZ Jetk e 5S (V j" tv�11" 19 - <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> Sav►- i4 C- G, 0S 5-7 <br /> State License Number(required) City of Everett Business License Number(required) <br /> /2- � <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage Of residential new construction, remodel or addition) tontact Verson/1 Number/Email <br /> l�Vy`✓l�y <br /> "A 19 <br /> Number of de ices (If low voltage) p�� , <br /> Description of Work to Be Done: �L�� �DJa-,G � / �V j7eyU% c <br /> G/n s l Ot- Qkk7 , <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 0 <br /> i <br /> l 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 or local law regulating construction or the E (S-0 n^ Io 16 <br /> performance of construction. That l am authorized by the owner of this property to perform the 7 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RC and <br /> 296.200 WAC. <br /> g4c 42-� <br /> 1/a <br /> Signature Date <br /> REVISED 06/06/2014 <br />