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� <br />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 />�`�'� ��������� <br />PROJECT ADDRESS <br />Y� �� � �- <br />Owner <br />Tenant <br />�,��':s� ��,�: ��" , <br />Electrical Contractor <br />� <br />�-�r <br />Mail Address <br />Mail Address <br />='�'� �_ <br />Mail Address <br />i��-1-G=�!..:LT �i�(.;�(s2 �-t� <br />State License Number <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />�l�' '��7�}�' <br />� � <br />City�✓ <br />C ity <br />.��'�.� <br />City <br />� <br />.�� � ��� <br />State/Zip Phone <br />State/Zip Phone <br />��]�'� i �i �� �ru�_�"� l <br />State/Zip Phone <br />� �U/��/ <br />Contract Price of Work <br />�'�;, - 'l�✓��'-���--� <br />Contact Person (Plan Review) <br />� j jL � ' 1 � �/G,�t �C'1'l ��'� ✓� ,/K � �`i� `W.�' 3 �-` l/U�-' Y� y � I'K�-�.,��.`'� ��-iJ1Jv4 Y'+'Ut"/V�l \ � �� <br />�s� {k �:�� =-a��U-��,�� �`�1� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that 1 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; f nstruction. That 1 am authorized by the owner of this property to perform the <br />work for wl,n{c�i�plicafion i ade and I comply with the Sfate Confractors Law 18.27 RCW and <br />296.200 V�//NC A /1 <br />Sigrlature <br />REVfSED 3/20/13 <br />FEE <br />�4-00 <br />PERMIT# <br />E � �a �- o�s _ <br />