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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� � �.�� �� ��— <br />PROJECT ADDRESS <br />�.;� ��►�r�is � C-� ��.� s C�u r3 �.3 ((� 12�`"� 5-r � v�R E-tr l.� �� 2 c�) �Z.� 2.�9. Sl 7 <br />Owner Mail Address City State/Zip Phone <br />�,� �rn � <br />Tenant Mail Address City State/Zip Phone <br />�RE��Q2� �LECT(Z1C � o� aox ��►� ��.,� �� w���a�-�� � z.s�-�3. 9��2 <br />Electrical Contractor Mail Address City State/Zip Phone <br />�. G, L.T- `� �I � C� �(O <br />Q2���E�q2� P�- <br />State License Number (required) City of Everett Business License Number (required) <br />���� �-��, �, � �.� � 3. fl�o °� <br />Proposed Use of Buiiding Contract Price of Work <br />� <br />Square Foo�age (If residential new construction, remodel or addition) <br />��� <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />L� oQN� � a�—L l'TN E� <br />Contact Person/Contact Number/Email <br />u���2GnouN <br />� , �2 , ►� � -�a C �� � c �s o �L�- d C � ) 5�2� Qo.arz� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerfify that I have read and examined this application and know the same fo be true and <br />correct. All provisions of laws and ordinances goveming this fype 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 1 am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Confractors Law 18.27 RCW and <br />296.200 WAC. <br />uate <br />REVISED 08/06/2014 <br />�a[27 9 <br />FEE <br />� �� �� <br />PERMIT# <br />E ����- l�� <br />