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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 />13IZ�, C - 0 \L3" <br />PROJECT ADDRESS '- <br />0. 0 D !A o 13 i 2�f�fZUI <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />Electrical Conttactor Mail AddrWs 'City State/Zip Phone <br />0tiWK& 8!a0 <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) I iE� <br />"V�CJ <br />Number of devices (If low voltage) <br />Description of Work to Be Done: -6-6 vX-1 + �A- -Ub CL Y C,v t fin+ N �- <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 authority to <br />violate or cancel the provisions of any other state or local 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 />296.2 &WAC. <br />FEE <br />PERMIT# <br />E I5 ),2 i <br />17 <br />REVISED 3120113 <br />