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� � <br />ELECTR�CAL 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 />����� "7��t� sf 5/'� ��,:�� <br />PROJECT ADDRESS <br />�j ,���c,/ G�/`� <br />/ ! l� /'_� y!�'9 i � r� , r S' (� � � t/ � � �'/ <� ST' '✓-''�"C- ". `ti ri.' /C" �'/� ! d �` �� <br />Owner Mail Address City State/Zip Phone <br />L�'�� _ `��% ~ s�" ���' <br />Tenant <br />Electrical Contractor <br />State License Number (required) <br />s��;� /� �.,�,��� <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />�I �C��. •� � <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />r.� r,� �'C�' e✓��' �,�- <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />City <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />.� <br />� j� � z� ��j � � <br />�r.��l/y���>•-�� ° -� <br />Contact Person/Contact Number/Email <br />� � <br />�t� ��� j�n 5 f?r c Ti c�r� . <br />1 hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. AU provisions of laws and ordinances goveming 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 loca/ law regulating construction or the <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 />� � /� <br />Date <br />REVI SED 08/O6/20 i 4 <br />FEE <br />���� <br />PERMIT# <br />E� � ��� - ��� <br />