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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 />� r � � ��' � �� �U� � � E Ue �.�-j'�' i�,�- <br />PROJECT ADDRESS <br />�5�i�� �Mw�. ��v�cl.� �1��W �'�-, /�-(,"C_ � G� �.���f�-�" i�v� �1 �20� <br />Owner Mail Address City State/Zip Phone <br />��3 " ��(o - <br />Tenant Mail Address City State/Zip Phone <br />�5�� <br />Z.7_�- �'3�.� �-ev �� <br />Electrical Contractor ✓ Mail Address <br />�S � �t�`� �1 ��� ��- <br />State License Number <br />���� � <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />�� <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 />0 <br />T � �� U�v �N'� <br />i <br />State/Zip � �Pbvyy�;� G� <br />�" � l ! <br />1�'; ��� <br />Contract Price of Work <br />`�'�,��'1 ���i�'Ce..SS <br />Contact Person (Plan Review) <br />! hereby certify that I have read and examined fhis application and know fhe same to be true and <br />correct. All provisions of laws and ordinances governing fhis 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 sfate or local law regulating construction or the <br />performance of construction. That 1 am aufhorized by the owner of this property fo pertorm the <br />work for which application is made and 1 comply with the Siate Contracfors Law 18.27 RCW and <br />296.200 WAC. <br />, <br />-ZS � <br />REVISED 3/20/13 <br />� <br />FEE . <br />�l.% � �� <br />PERMIT# <br />E � ���� — � � �I- <br />�� I <br />�� � <br />� <br />