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Dec, 10. 2015_ 8 : 57AM So nd Secur i t Inc �No. 0204—P. 3-- <br /> ELECTRICAL <br /> --ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EV,�RETT, WA 98201 <br /> 425-257-8810 -'' FAX 425-257-9857 ,wvvw-everettvva,org <br /> PROJECT ADDRESS <br /> zj� � <br /> Llk( <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Contractof Mail Address City State/Zip Phone <br /> State Llcense Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Square footage (If residehtial new constructli n, remodel or addition) Contact Per on/Contact Number/Email <br /> Number of devices (If low voltage) <br /> "�a <br /> " <br /> Description of Work to Be Done_ . � � <br /> . k <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE[5 3105 � <br /> I 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 goveming 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 otherstate or local law regulating construction or the �� ���d (p <br /> Performance of construction. That I am authorized by the owner of this property to perform the l�j <br /> work for which app/icatlon is made and/comply with the State Contractors Law 18.27 RCW and <br /> 296.20pj WAC. <br /> — Signature Date <br /> r�eVlSEo osrocrzo 14 I .— <br />