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ELECTRIC�►L 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 />�J� ZC'�G �`� ����•)IlS' `� <br />PROJECT ADDRESS <br />G r�5 f � <br />Owner <br />�� <br />Tenant <br />s` � �I�J i. � <br />Electrical Contr <br />Mail Address <br />b <br />Mail Address <br />S.�GL>>� � �ti <br />Mail Add ess <br />5!� 1� 7�i l c'. s -`�! z 5 �YVI Z-. _ <br />State License Number (required) <br />� <br />��� � � ��� j � <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />%� <br />Number of devices (If low voltage) <br />City <br />C ity <br />�z����U�1-Z <br />City <br />State/Zip <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />Phone <br />t{ S �� � �2 <br />City of Everett Business License Number (required) <br />�3���5� `����� <br />Contract Price of Work <br />I�� v��l� �+� 12 �! � A 2Q ����g6� �3 A�,� , � <br />Con�t�e�son/Contact Number/Email <br />--� -- 9 �s' � � ct Z 5 <br />Description of Work to Be Done: �^ 1 il -p A�/� /! .iJ�it � 1 l� -•� S 1� ���i S� S U-�'� <br />F� • <br />� <br />/ C7 / �!L �. L <br />� <br />S� v 1C P . �'� � �l �.I � < � -� u 'r'� J L � s ) �7 �% i'�..o S �� U �r� �,-� �` [ii3O,� `/ < � <br />—� <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ��� �-5 <br />� <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 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 pERMIT# <br />violate or cancel the provisions of any other stafe or local law regulating construction or the �����_�� I <br />performance of construction. That I am authorized by the owner of this property to perform fhe <br />work for which applicafion is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. „ ,� n a <br />^2 �i �--2.G�' <br />nature <br />REVISED 08/06/2014 <br />v..� <br />