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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 />1`�''�� �_-► I°� t�,� - E►�� r' ", I,�; (-�- `� X z�� 3 <br />PROJECT ADDRESS <br />I�,�� `i I'' Sf w; i`t�c;�' `i�`�' ��T Jt� 2iC' ��r�v�fi �U(� ���>i1:�7 <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />l�� �-11�► <br />Mail Address <br />.--- e -�f'_ � <br />Mail Address <br />��, ���y�����;e�� c�� <br />State License Number <br />� �'i � <br />Proposed Use of Building <br />c�i�� <br />Square Footage (If residential new construction, remodel or addition) <br />i� <br />Number of devices (If low voltage) <br />City <br />City <br />t:.�- �Z�2 <br />State/Zip <br />C c' � L <br />State/Zip <br />� i,C�B"L <br />Contract Price of Work <br />�i��v� kri� t�1�J <br />Contact Person (Plan Review) <br />Description of Work to Be Done: 1'�e�Q�-(.Z-� ����t.J�J�G���. ��C��7 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />l hereby certify that 1 have read and examined this appJication and know fhe same to be true and <br />correct. AII 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 authorrty fo <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of constructron. That � am authorized by the owner of this property to perform the <br />work for which a{�plication is made and ! comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />re <br />REVISED �'2CY73 <br />Phone <br />Phone <br />% ��,%��L J�'� �c� . <br />FEE <br />�C�cr� <br />PERMIT# <br />E � �D � -�U�,� <br />