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Al <br /> ELECTRICAL PERMIT&APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EU�fJETT, WA 98201 ' <br /> 425-257-8810 -' FAX 425-257-8857, , ,, /ww.everettwa.org <br /> +10- 1 <br /> PROJECT ADDRESS <br /> Owner <br /> Mail Address City State/Zip Phone <br /> 6 <br /> r ► C � 4- . <br /> 26�, 7i y--�� -7 �-- <br /> Mail Address City State/Zip ��(( _ Phone <br /> Tenant <br /> ►�rol ��ic. 0?�2J 61 EW ZSFl-3� - <br /> n Mall Address ;I,i City State/Zip Phone <br /> Electrical Contractor <br /> CT �� D� <br /> State License Number(required) 3 ) <br /> City of Everett B-u�siness License Number(required) <br /> r\ t < ) <br /> Contract Price of Work <br /> Proposed Use of Buil Ing <br /> Lu L4 <br /> Square Footage (If.residential new constructio�t, remodel or addition) <br /> Contact Per on/Contact Number/Email <br /> Number of device (If low voltage) ' <br /> Description of Work to Be Done: <br /> V.E � <br /> FEE <br /> ofCITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � I <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 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 <br /> erto perform the <br /> construction. <br /> s made and lacotmply with the State Contractorsl �aw <br /> performance of cont18.27 RCW and Ib / <br /> work for which apple <br /> 296.20 WAC. <br /> I.1. — t&g <br /> Signature <br /> REVISED 06/06/2014 <br />