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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 /> - <br /> / �V� WP <br /> �o PROJECT ADDRESS <br /> t 0"-'C�Q I-- Vl-\\ [ Ycv I,-,- <br /> Owner <br /> s Owner Mail Address City State/Zip Phone <br /> �ywC�2•/ iV\tI1 eC,fit 5(,, a� �1 Luere. <br /> -K 1N t4 R820z, <br /> Tenant Mail Address City State/Zip Phone <br /> 'VV 41's <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> loo <br /> Proposed Use of Building Contract Price of Work <br /> j-•fir �`/S�ne rtCm <br /> .nom <br /> Square Footage (If residential new construction, remodel or addition) Cont�'erson/Contact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: L. K Tcj ('0 DC <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 gg <br /> /hereby certify that/have read and examined this application and know the same to be true and l �� <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# y <br /> violate or cancel the provisions of any other state or local law regulating construction or the E <br /> performance of construction. That I am authorized by the owner of this property to perform the // <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> " Signature / to <br /> REVISED 08/06/2014 <br />