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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 /> f� �� q � <br /> ��I7 �� Vll ���4 �-� � a, <br /> PROJECT ADDRESS ��3�� � <br /> l�� � "✓'I,��'�' �jl•�-tti`�- �.�/i(/'�`�" I��ti� ��v'Z�� <br /> Owner Mail Address City State/Zip Phone <br /> ��/�-//1/'�_, <br /> Tenallt Mail Address City State/Zip Phone <br /> /��" 1 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> � �-� . � � <br /> State License Number Contract Price of Work <br /> �j��si�,,�o (�Z,��t�� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage (If residential new construction, remodel or addition) <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: ��!'�fl✓�� ��l.l.Z f.� �� G� ���-� ` t'�'� �G"f I r�-� <br /> 0+� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 -����� �!/� <br /> �� __- <br /> � �_ <br /> 1 hereby certify fhat l 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 comp(eted <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 state or local law regulating construction or the � <br /> performance of construction. That 1 am authorized by the owner of this property fo perform the E II �' � � � ��� <br /> work for which application is made and I comply with the Sfate Contractors Law 18.27 RCW and � <br /> 296.200 WAC. <br /> � �"� � � <br /> Sign ture °� te <br /> REVISED 3/20/13 <br />