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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 />��C�� 3��`'` � V� � v ��- �� c� <br />PROJECT ADDRESS <br />�V.�c�Q_Y f(Y` i �1 � � <br />Owner Mail Address City State/Zip Phone <br />S v +�f-e- ( �o <br />�,z�-�J Mll� : M � c S l.� n� _� P�o '�0 5 3�'�''� ti� 1,� �,�r� H� In�►� Q g 203 <br />Tenant Mail Address City State/Zip Phone <br />C� P ti �I�e.c..-��i c I �►� 32s w�,��,����>,. Av� S�a� K�N�r W Kl- `t B� 3Z zs 3 P��2 r� <br />Electrical Contractor Mail Address �� City State/Zip Phone <br />n�,s���( �31 �'� <br />tate License Number (required) <br />roposed Use o Building <br />Square Footage (If residential new construction, remodel or addition) <br />S <br />Number of devices (If low voltage) <br />C�y�I�Z <br />City of Everett Business License Number (required) <br />� � ��D � �� <br />Contract Price of Work <br />�,Yt�y � 253-8�,2-19oS 5e�y��Is�eJe <br />Contact erson/Contact Number/Email �.e,� <br />Description of Work to Be Done: ��ST�� F �� �L�� � I �)(Z T� �(� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <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 <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That 1 arn 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 <br />REVISED 08/062014 <br />FEE <br />� ��. � <br />PERMIT# <br />E ��j�-0�� <br />