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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 />IFJ�� (j��(�'S �¢p/� �!/E2�T <br />PROJECT ADDRESS <br />� ��Mr A <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />City <br />City <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />� N�i�/i�r� �l���j►��� 5 ��i� �3� �v� 5� �/Ew��>�� �� �i�'��.�� �� ��x�=�yy�y <br />Electrical Contractor Mail Address City State/Zip Phone <br />livr=j�,�� 9�1z f � <br />State License Number ,� <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />��-v <br />/ , � �% <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: �`��' �✓� � � � i � � C� �f � „I'//'i ' 'T �v ✓ ,��Gt/ /_'�� CJ �? r�vMf' �(/�4 �/�/C <br />p1 u i� _'1- �' O �> A�-'i t� F-' v c� /�( f <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that l have read and examined this application and know the same io be true and <br />correct. All provisions of laws and ordinances governing this type of work will he completed <br />whether specified herein or not. The granting of a permif does not presume to give authority to <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 prope�ty to pertorm the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296. 200 WA C/ <br />� <br />�� D7 /L�% 1.3 <br />re <br />REVlSED 3/20/13 <br />Date <br />FEE v <br />� l , � <br />PERMIT# <br />E��v�-��s <br />