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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 FAX 425-257-8857—www.everettwa.org <br /> PROJECT ADDRESS <br /> L,-4A 737,3 qZ^ 53-gz-7o <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mall Address City State/Zip Phone <br /> Electrical Contractor Mall Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> *5775 . <br /> Proposed Use ofBuilding Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(It low voltage) <br /> Description of Work to Be Done; <br /> FEE <br /> CITY OF EVERETT LOCAL.SALES TAX CODE IS 3105 ��o c <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 i am authorized by the owner of this property to perform the r D <br /> work for which application is made and I comply with the State Contractors Law 95.27 RCW and t <br /> 296.200 WAC. <br /> Signa re Pate <br /> REVISED ON612014 <br />