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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 />( `l rtl2 <br />I � �� �- ��� � _ � _, . -� �f �,,� � <br />PROJECT ADDRESS <br />/rl �' C� /l ��'%�-�' `,- <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />�� r.����������1 <br />ContraCtor fGlail Address <br />%f�'/�L'�7'� O � � (� � <br />State License Number <br />—�c/ t'� I.�VL�� <br />Proposed Use of Building <br />City <br />City <br />S Sz�J �?e �w��� <br />City <br />Square Footage (If residential new construction, remodel or addition) <br />� <br />Number of devices (If low voltage) <br />Description of Work to Be Done: �� u! �✓f�l r a� � C_�O( !4 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�vr <br />State/Zip <br />State/Zip <br />�� ��Q� <br />State/Zip <br />Phone <br />Phone <br />� � �s� .so.� ���f. ��i <br />Phone <br />� �� � <br />Contract Price of Work <br />Contact Person (Plan Review) <br />I hereby certify that I have read and examined this application and know the same to be frue 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 sfate 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 hich application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.20 WAC. / ' <br />uate <br />REVISED 3/20/13 <br />�� . � �v,�� s <br />��,�-��,� <br />FEE <br />�-%(.' - l.' �l <br />PERMIT# <br />E ( �� C� �� �-1 L� �� <br />