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• <br /> ELECAICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857— <br /> e, z v4 re.44e 5 � e-ve--reW ewea, ,-i, a Jv <br /> --7 <br /> PROJECT ADDRESS <br /> C1 <br /> Owner Mail Address City State/Zip Phone <br /> 'TM/LP <br /> en- <br /> Tenant Mail Address City State/Zip Phone <br /> PG P"')X. 4 UG '71 � 0 �3 <br /> Electrical Contractor, Mail Address city State/Zip Phone <br /> uq <br /> State License Number(required) City of Everett Business License Number(required) <br /> 1�9 f�tzo'lpovt 5 - .4, ��00 0✓ <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(if residential new construction, remodel or addition) Contact Person/Contact NumberlEmail <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE 13 3105 <br /> /hereby certify that/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 pennit does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state orlocal law regulating construction or the <br /> performance of construction. That/am authorized by the owner of this property to perform the E i 5 <br /> v V 6$work for which application is made and/comply with the State Contractors Law 18.27 RCW and <br /> 296,200 WAC. <br /> Signature bate <br /> REVISED 0610612014 <br /> r3 -Tb 41� <br />