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ELECTRICAL PERMIT �4PPLICATION <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 <br />� 7 �U�� S�- �.� � 11e��-��; � � � Z�%' <br />- l� 7 <br />PROJECT ADDRESS <br />, � �,,� � �.�c��2 � <br />Owner <br />Tenant <br />CJ V�/ YI � f <br />Electrical Contractor <br />j �U� 7�U�� �;�. � (� � ✓�-�� �{ (,�/ � � �6 Zo `� <br />Mail Address <br />Mail Address <br />Mail Address <br />State License Number <br />� � � <br />Proposed Use of Iding <br />��� � <br />Square Footage (If reside tial new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />1 I��ln�- . 1 Ou�l�- <br />��Gll�� � lZJ ��.C.`CU1 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />City <br />City <br />State/Zip <br />State/Zip <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />� � 1 � j�q u�-}a ; .�� v\ <br />l� � <br />r� <br />1 hereby certify that I have read and examined this application and know fhe same to be true and <br />correct. All provisions of laws and ordinances governinq fhis iype of work will be completed <br />whether specified herein or nof. The granting of a permit does nof presume to give authorify to <br />violate or cancel the provisions of any other sfafe orlocal law regulating construction or the <br />performance of construction. Tl�at I am aufhorized by the owner of this property to perform the <br />work for whic plication is made and I comply with the State Contractors Law 98.27 RCW and <br />296.200 WA . <br />v� W c,'�,`� `� � l� �� 1 <br />Phone (� <br />5'�`-'�-�i Z 1�47 <br />Phone <br />Phone <br />FEE <br />�Uc� <br />PERMIT# <br />El�{�� �ll� <br />