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11/10/2015 17: 20 4254897996 HOME RUN ELECTRIC PAGE 02/02 <br /> 10 0 <br /> 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 /> 0,/ Fe&ln/ Avo <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 /> state License Number(required) City of Everett Business License Number(required) <br /> t'� �CfC'�1 <br /> � �� <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: <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ( c5 — cy�-7 <br /> I hereby oertify 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 Cloys not presume to give authority to PERMIT## <br /> violate or cancel the provisions of any other state or local law regulating construction or the r 15U� <br /> performance of construction. That/am authorized by the owner of this property to perform the t <br /> work for which application is ma a and I comply w'h the State Contractors Law 98.27 RCW and <br /> 296.200 WAC. • <br /> 100 <br /> Signature Date <br /> aEvlsgp oa osnoaa <br />