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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 />_ � �� � <br />�� � �" � ' t?�'�-� J v <br />PROJECT ADDRESS <br />i4 <br />\ %.� '� � � � � �,� '1i�`� c' �l , � , �, �`� \ � "� <br />Owner <br />Tenant <br />( ") �,'J ��-e:r-- <br />Electrical Contractor <br />State License Number (required) <br />Mail Address <br />Mail Address <br />Mail Address <br />� �,� ��� - <br />C ity <br />City <br />City <br />� <br />�_� � b����. ��, �1 �c ► 2 <br />State/Zip Phone <br />�Z� �� � � ��� <br />StatelZip Phone <br />State/Zip <br />Phone <br />City of Everett Business License Number (required) <br />'� r , : � � � (��� �� <br />Prop sed Use of B Idi�g C trno act Price of Work <br />��� � � � � �^� i ��c� v � �� ��✓� � �" <br />Square Footage (If residential new construction, remodel or addition) Contact Person ontact Number/Email <br />" 11 �. <br />���.1(�r���'�'��C�L :V�c � ���� ((� i./�t ���,j�. <br />J <br />Number of devices (If low voltage) <br />� <br />Description of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />� �-> 1-� �l <br />m <br />I hereby certify thaf I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances goveming this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authorify fo <br />violate or cancel the provisions of any other sfate or local law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which�pplication is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAG. <br />re <br />REVISED 08/06/2014 <br />FEE <br />��. <br />G� �; <br />� � <br />PERMIT# <br />E��:' i�( � z- - r, t�: `� <br />