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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 />� ��L�-� �-- - �,���,, f,� /%�`,1 ��,�,`� <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />City <br />State/Zip <br />Phone <br />,�-���I S <br />Tenant Mail Address City State/Zip Phone <br />�'j-�S�" ��e��r���, �GiS ,�(;ls�� :S�t� Sl,� <br />Electrical Contractor Mail Address <br />P��:S�rc-�-�y�� s� <br />State License Number (required) <br />�=�G�� . e�r .�- <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />State/Zip <br />- �� _ ;�� <br />Phone <br />� I"/YU� J� <br />City of Ever�tt Business License Number (required) <br />��-�`�UC'.�.�� <br />Contract Price of Work <br />�S�►n��s L-�� �C�� C� �`l-�6�� <br />Contact Person/Contact Number/Email <br />5�� rn-e ��� % t'>+ � l�c;�'� � 5� �<<�t�i�. Cc <br />1 hereby certify that I have read and examined this application and know the same fo be true and <br />correct. All provisions of /aws 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 1 am authorized by fhe 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 />296.200 WAC. <br />� <br />Signature <br />REVISED 08/06/2014 <br />/� <br />FEE <br />�1 � �� <br />PERMIT# <br />E ����- ��� <br />