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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 />� j L, � �,� � I �'� �v'�/`e . <br />� <br />PROJECT ADDRESS <br />`�� «����� G11,- i �,�,� � � �-� I "� � � ��> L- � � .' � �� �,��-� � � � `-� �� �� �� <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />�� ��` <br />Electrical Contractor <br />State License Number <br />Proposed Use of Building <br />Mail Address <br />O � „ .�r-- <br />Mail Address <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 />� <br />C ity <br />City <br />� �. <br />�, ^ � 41 1� P <br />���? P�� � t �� �. `� <br />State/Zip <br />State/Zip <br />Z J n, v <br />Contract Price of Work <br />Contact Person (Plan Review) <br />����� ��i��� <br />. <br />� <br />� <br />� <br />Phone <br />Phone <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE 15 3105 `� <br />���.C�� <br />I hereby certify fhaf I have read and examined this application and know the same fo be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specifi herein or not. The granting of a permit does not presume to give authority to PERMIT# <br />violate orcan el the provisions of any otherstafe orlocallaw regulating construction orthe <br />performanc of construction. That I am authorized by the owner of this property to perform fhe E C�j �� —� j`� <br />work for w ich application is made and 1 comply wifh the State Contractors Law 18.27 RCW and <br />�`-(2 S' `-� � � I �' y s� <br />REVISED 3/20/13 <br />�� � � / � <"' ( <br />