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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� ��`'-� S� Sl� <br />PROJECT ADDRESS <br />� <br />� �a�;h� �����o�.� ��r3 50� �' S� �-��� i�� Y�?Zo3 2sZ--�2�(� <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />� <br />Electrical Contractor <br />State License Number <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />� Z Ov <br />Square Footage (If residential new construction, remodel or addition) <br />�J <br />Number of devices (If low voltage) <br />Description of Work to Be Done <br />City <br />C ity <br />��.L OC�!'�i1� J � � � ��- �kC <br />State/Zip <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Phone <br />Phone <br />-1 v cA �1=. 0�% 5i� �t. <br />�' 2 � I/� A L �'Ez t���-P�C, �� �' � U�,� �'� �/I-�C. 1� � W� t-t�� ,�` 1� C, �U (,v/�rt2� t� I/�.� . <br />U <br />:� �� �' � i S�(,iJ-�� L,� I Z O I�P<<- t� rJ G�/,%�.n� <br />r�,Li,�� 2 G c ►�-u.� � ) <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 authorify to <br />violate or cancel the provisions of any other state or local law regulating construction or fhe <br />performance of construcfion. That I am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply wifh the State Contractors Law 18.27 RCW and <br />296.200 WAC. _ <br />REVISED 3/20/13 <br />FEE <br />� � �'� <br />PERMIT# <br />El�i�- a�� <br />