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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 />-� 5 I osy� �L �� Ev.�.r t�- q� a o� <br />PROJECT ADDRESS <br />QI -�- -� YY1 a� q v�c.. r i� 1�- �C� sY�.c S ��- � 9 5.�-5 0• O Q <br />Owne� Mail Address Ciry State/Zip Phone <br />Tenant <br />Mail Address <br />Ciry <br />State2ip Phone <br />��wvu�.r. L�.a.-I�, r�q y l. o I� � 3� �L 5��1-� c�uo� q�I to8 �oe ��I e� v <br />EleCtriCal COntrdCtor Mail Address City State/Zip Phorte <br />���,�q �a � <br />State License Number (required) <br />��� <br />Proposed Use of Building � <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />O� �� 3 O <br />City of Everett Business License Number (required) <br />�3b� <br />Contract Price of Work <br />' � D�•��'8. 00 <br />Contact Person/ ntact NumbedEmail <br />of Work to Be Done: I(i\7 i� � r �. ��� �io 1� l.iw W',' -� �� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />f hereby certity ihat ! have read and examined this application and know the same to be true end <br />correct. All provisions of laws and ordinances goveming this type of work wiU 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 1 am authorized by the owner of this property to perform the <br />work for whrch application is made and ! comply with the State Contractors Law 18.27 RCW and <br />'£916. 200 WA C. <br />REVISED 08N620J� <br />FEE <br />��� <br />PERMIT# <br />E l�r�-l�7 <br />