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ELE�TRICAL PERiVIIT APPL.i�ATION <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 />/ � <br />PROJECT ADDRESS <br />l.� <br />Owner <br />Mail Address <br />� <br />City <br />�-�G 9%��3�0� <br />State/Zip <br />Phone <br />•%���'tv ���i� 1 ��✓00�2 %�'"�rJ ��� <br />Tenant Mail Address City State/Zip Phone <br />.ti"�'�;°�'i <br />Electrical Contractor Mail Address City State2ip Phone <br />State License Number (required) City of Everett Business License Number (required) <br />� � �i <br />���� � �������a: <br />Proposed Use of Building Contract Price of Work <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Contact Person/Contact Number/Email <br />' ` � %.` �S � ���� <br />Description of Work to Be Done: �//�//�G «`" �� � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that f have read and examined this application and know the same fo be true and <br />correct. A!I 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 fo <br />violate or cancel the provisions of any other stafe or /ocal law regulating construciion or the <br />performance of construction. That f 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 WAC, / <br />re <br />REVISED 08/O6/2014 <br />� .'"_ � �—S <br />FEE <br />� II� �/� �/ <br />l!C l5/ v <br />PERMIT# <br />Ee�IZ�c�� <br />