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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 />� �Z C�1�S+1��� �� � � <br />PROJECT ADDRESS <br />�C�c���,� ����5 :��z,2 � l�'=���.e � 1�ccJ�ySv; f l� �fi�Zx� �z� z`ti7��y <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />��� ti �� <br />Electrical Contractor <br />Mail Address <br />Mail Address <br />����c.� ��-c� i �. i��Z <br />State License Number (required) <br />T�y`'� v'^ 7c': �:-� 4r <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />City <br />City <br />StatelZip <br />State/Zip <br />Phone <br />Phone <br />f��3`� � �7 <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />�J�c i �+c�c�c�: �2��JZ�r��-2Yz9� <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: 1 �'�� � �� l f C�i C 4' <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 provisrons 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 construction. That I am authorized by the owner of this property to perform the <br />work for which application is made a I comply with the State Contractors Law 18.27 RCW and <br />296.200,JNAC. A . /I ' � <br />�-��-�5 <br />REVISED 08/06/2014 <br />FEE <br />)` <br />���� <br />PERMIT# <br />E ��, �" `� - � f I <br />