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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 />� � �� ��5-�-�, � 7- s� � �- �t r E- � �,.�✓-� <br />PROJECT ADDRESS <br />Lti�. ��i �<� n <br />Tenant <br />Electrical Contractor <br />�'11L� .�'� L � � ! � � <br />State License Number (required) <br />Proposed Use of Building <br />� L �= <br />Mail Address <br />Mail Address <br />�,r G� <br />Mail Address <br />: �-, v � <br />City <br />City <br />L� ;��. <br />City <br />Square Footage (If residential new construction, remodel or addition) <br />N mber of devices (If low voltage) <br />Description of Work to Be Done: <br />�f� <br />C �ti E v <br />i �'� �' �� �' <br />� /"� �`t � C � <br />State/Zip <br />State/Zip <br />. <br />! (�.�,� % <br />State/Zip <br />��' �'� �.�'G'�'.s' <br />Phone <br />Phone <br />v� � y�� 7 � <br />Phone fl7�ti� <br />QS �.5�5 <br />City of Everett Business License Number (required) <br />�Z 5 � �, <br />Contract Price of Work <br />(,� �'�� � � r�,`��� �, yzs- �� � ��� <br />C�ct Person/Contact umber/Email <br />//�� � <br />[ c� r' 'Y-ti f <br />`�►, C o � �-� �Gt �' .-G r �-,-� �- <br />Ci �^� l C' ,Y�C� �.....i C � <br />c^� r <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ���v <br />1 hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. AI! 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 PERMIT# <br />violate or cancel the provisions of any other state or local law regulating construction or the �,^� ,�� � �. �-\ ` <br />performance of construction. That 1 am authorized by the owner of this property to perform the V� � (�(� I <br />work for which application is made and I comply with the Stafe Contractors Law 18.27 RCW and <br />296.200 WAC. <br />l <br />REVISED 08/O6/2014 <br />