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� � <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 />l (� � � � EU� �r� � � <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Electrical Contractor <br />Mail Address <br />Mail Address <br />SGIS� .���0� ` <br />Mail Address <br />��57��� ������ <br />State License Number (required) <br />C �:�rw6? ��. i�� <br />Proposed Use of Building <br />City <br />C ity <br />�C� L�hNv<%G�v <br />/� 5 � �' <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 />� <br />State/Zip <br />State/Zip <br />���.� <br />State/Zip <br />Ph�ne <br />Phone <br />h�9-�G � <br />Phone <br />o��6f 0 <br />�y of Everett Business License Number (required) <br />3vc�v; �'�' <br />C�ntract Price �f Wmrk <br />VC1 bi1 X s G- C'.l� /.Z U{.�j% J� -%L� �i'' i <br />Contact Pers n/Contact Number/Email � <br />.c1 �'.� Y►'U� ����7QGPC OY�C S-�� . GO�J <br />I hereby certify that I have read and examined fhis 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 />296.200 WAC. � <br />REVISED 08/O6/2014 <br />5�E'C <br />FEE <br />i � '2- 5-° <br />PERMIT# <br />E � � 0�� I'�� <br />