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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 />(�2�� !(2`� S�- �C S� L. <br />PROJECT ADDRESS <br />Owner <br />� <br />�-vv� a�y �e � c�i✓� Y <br />Tenant <br />�� 4��� L� � l��l L <br />Electrical Contractor <br />�1 ✓��yC� j CS`� <br />State License Number <br />Ca' ja7 m,-� ✓ C( �i l <br />Proposed Use of Building <br />Mail Address <br />� �t,L'�'�' GL S C� �4 v'F' <br />Mail Address <br />� �JG � <br />Mail Address <br />� I� �i <br />City <br />c�tv <br />�- � u,/ `�� I G j � <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />City <br />State/Zip <br />State/Zip <br />� ��^ � �� �r <br />State/Zip <br />� fl � S� <br />Contract Price of Work <br />Phone <br />Phone <br />z5��S72o c: <br />Phone <br />Contact Person (Plan Review) <br />Description of Work to Be Done: �(% �� �� �� ��t'1"� / �G�'`p/ ( L157'�f G/ (�S vC� <br />`� %' � �D% 5 , <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 to be true and <br />correct. All provisions of laws and ordinances governing this 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 state or local law regulating construction or the <br />performance of consfruction. That I am authorized by the owner of this property to perform the <br />work for which applicatioryi� made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. / / <br />10 - 2�-- � 3 <br />REVISED 3/20/13 <br />FEE <br />Z�Z Z `� <br />PERMIT# <br />E ����� �5 � <br />