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• <br /> ELEC ICAL 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 /> ( 1g <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> 1tZ u; L-er 11") J{z9(o ��2k�9 /�lK N 57 ! J �� Z `IZS iyG v)-57) <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> rEG-ST ql-F71)1— 0S3 1447 <br /> State License Number(required) City of Everett Business License Number(required) <br /> GG '� <br /> 3 L�ZT <br /> Proposed Use of Building l,ontract Price of Work <br /> ?Ir 25" 35-3 -71(. t <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: (.J "N t,3 s L ��z N4-k L 6-0-e-1-7C_Gt-i I <br /> (/t�1-11 C--. 2 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 1 0 <br /> I 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 E �� ^ 0(2performance of construction. That!am authorized by the owner of this property to perform the ) <br /> work for which a..Gcation is made and!comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC <br /> Signa re Date <br /> REVISED 08/06/2014 <br />