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• - - ELECTRICAL PERM Tzz <br /> APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EU� ETT, WA 98201 <br /> 425_257_8810 =' FAX 425-257-8857,, !rwvw.everettvva.org <br /> PROJECT ADDRESS <br /> Mall Address City State/Zip Phone <br /> Owner ql-" <br /> Mall Address t, City State/Zip 'rPhone <br /> Tenant <br /> S <br /> e r� City State/Zip Phone <br /> Electrical Contractor Mall Address ;. i!ji <br /> City of Everett Business License Number(required) <br /> State License Number(required) <br /> 1xv . c20 <br /> Gi ����� Contract Price of Work <br /> Proposed use of Building <br /> L. L4 Z-5 <br /> Square Footage (I.f residential new constructio,, remodel or addition) <br /> Contact Per on/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 c <br /> 1 hereby certify that 1 have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this it does not pe f work will give aube thority to PERMIT# <br /> whether specified herein or not. The granting of a p y <br /> violate or cancel the provisions of any other state qr local law regulating constructionto or the <br /> the <br /> performance of construction,'s made and 1 coThat I am tmply with the State Cont ahorized by the owner.of ictors awy18.27 RCW and <br /> work for which application <br /> 296.20 WAC. <br /> Odte <br /> Signature <br /> REVISED o6/U6/2014 <br />