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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 />+`���`7 11Z�~ S�"`'G /�.- ( <br />PROJECT ADDRESS <br />Mail Address <br />City <br />State/Zip <br />Phone <br />�- ( I� � I� H ��ac � nna �' I �a � �. <br />Tenant Mail Address City State/Zip Phone <br />�-(25 -Z9�, <br />�,�s `�"a� � ���c-� c i�i,C 2Z3� .��s ,� � �-� t,�,� �4 f � � 3 �76 � <br />Electrical ContraCtor Mail Address City State/Zip Phone <br />��C�� i �� ���t � � <br />State License Number (required) <br />��' �'- � � <br />Proposed Use of Building <br />�� <br />Square Footage (If residential new construction, remodel or addition) <br />� <br />Number of devices (If low voltage) <br />City of Everett Business License Number (required) <br />`Z: �a <br />Contract Price of Work <br />i��Z��-5'�S�-���"L <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: ���-�� """�� �� v`� � <br />� :.�`�--��`� � w� �� , �� z C7 ����=�' <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that 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 fype 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 state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 98.27 RCW and <br />296.200 WAC. <br />� `��.-, �`��Z�' <br />REVISED 08/06/2014 <br />�=21 -1 <br />FEE <br />� �� cL, <br />PERMIT# <br />E 1 ��-(�� _ I 3 � <br />I�-F��-v� <br />