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• <br />u <br />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 />�CGIJ``� �;� -��� Jt J��-' �)u;�e. �.C�' <br />PROJECT ADDRESS <br />� �1b��� C�'� � lu� E11; ��i ,t��e L�,' #3 n; .�h�.�iC' GC�,`� � ��'�� % <br />Owner Mail Address City State/Zip Phone <br />� �L <br />�� � �rG�\ 1�01-' %,7 �' .�t `a... :;,.,,iY. Zl�,` �Ve � C c► Cl,`,� .�l � � �%J <br />Tenant Mail Address City State/Zip Phone <br />C%�1"l �tf�e�,��n��; �.�,�;1 La������; ��. �cx ��c�,� K� � k:�� <br />Electrical Contra or Mail Address City <br />C..`� �= �'1 H �' % ;��5�3 C�� <br />State License Number <br />�.J(� In� c <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />I <br />Number of devices (If low voltage) <br />;.�i J `i b� Yz5 =��2�-1z�, 3 <br />State/Zip Phone <br />.� � �'C` . E� <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: �(l�iG. � I � I��ed.� �4�����'�U ✓��i � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All 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 ofher state or local law regulating construction or the <br />performance of construction. That ! am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAG. <br />re <br />REVISED 3/20/13 <br />� ��-,��; �<<; <br />., <br />-��,�-r; <br />FEE <br />PERMIT# <br />E l�o�� �i/ <br />