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ELECIC.AL <br /> PERMIT AP*PLICTI®fV <br /> CiTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857- <br /> dLa(c i z v-o re,44 e �P '-lbw re-ttY eeja j 4 f <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> PG' P")X rw-L '-' i ` L �'31 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business Licgnse Number(required) <br /> 41 <br /> p� <br /> Proposed Use of Building Contract Price of Work <br /> 1. -a G-Va tq 1j SSC'` 1.G_yvl lC�lit. JLJ t.1 -iNiG i fit;}�J� <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: � 'S 1 1L1 C��L y $AV i!4 FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> /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 /> performance of construction. That/am authorized by the owner of this property to perform the E <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and I <br /> 296.200 WAC. <br /> Signature Date <br /> i <br /> REVISED 08/06/2018 t'`/� -76 1 (f 9 <br />