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ELECTRICAL PERMIT APPLICi4TI0iV <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 />�G�' C� -, v ���i,���� <br />PROJECT ADDRESS <br />(� �; r . G� �C � <br />�1�� h /.r/�1//I / `'✓�� �r�r:.�SL� �G����� <br />Owner � Mail Address City State/Zip Phone <br />��— <br />Tenant <br />��s��� �'l�c �; � <br />Electrical Contractor <br />State License Number <br />! `—� ,5 - <br />Proposed Use of Building <br />Mail Address <br />Z l G 1�c �.�- <br />Mail Address <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: f� t'it�� /"C'G�4�'� � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />C ity <br />�� m <br />State/Zip <br />Ci �G �i% <br />State/Zip <br />Contract Price of Work <br />Phone <br />��-��r' �% <br />Phone <br />Contact Person (Plan Review) <br />I hereby certify that 1 have read and examined this application and know the same fo be frue and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or nof. 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 construcfion or the <br />performance of construction. That I am authorized by the owner of this prope�ty to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />; � � <br />nature <br />( � '— <br />FEE <br />1� ��� <br />PERMIT# <br />E � �f �� �._ b�v �� <br />