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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 />-1 -1 Q`d C)ev rAC- <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />Tenant Mail Address <br />Owner <br />Electrical Contractor v Mail Address <br />State License Number <br />City <br />City <br />-7-Di-i3 <br />Slate/Zip <br />State/Zip <br />State/Zip <br />Contract Price of Work <br />Proposed Use eoofBuildingContact Person (Plan Review) <br />. <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: C° U3 \r(a, e, n \ t F A-) lz� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have mad and examined this application and know the same to be true and <br />correct. All provisions orlaws 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 fire <br />performance or construction. That/ am authorized by the owner of this properly to perform the <br />work for which application is made and/ comply with the State Contractors Law 18.27 RCW and <br />296, 200 WAG <br />Phone <br />Phone <br />Phone <br />FEE <br />PERMIT# <br />E 130q - Uoj <br />nevisEa vmtj <br />