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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 />711-"�ST,5W, q02O-3 <br />PROJECT ADDRESS <br />CO it�, �ve✓c <br />Owner ail Address City qQ2!2`1 State Zip czn/ Phone <br />/ <br />Tenant Mail Address City State/Zip Phone <br />0 L-✓ ✓1 <br />Electrical Contractor Mail Address City State/Zip Phone <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Square Footage (If residential new construction, remodel or addition <br />I Iz <br />Number of devices (If low voltage) <br />Description of Work to Be Done: M �,4 <br />1 <br />I <br />FEE r� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 O�v <br />'hereby certify that l have read and examined this application and know the same to be true and <br />;orrect. All provisions of laws and ordinances governing this type of work will be completed <br />vhether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br />iiolate or cancel the provisions of any other state or local law regulating construction or the , <br />)erformance of construction. That 1 am authorized by the owner of this property to perform the E I q o _ l <br />vork for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />?96.200 WAC. <br />Cinnoh o nafe <br />