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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.everettwp...org <br />1 80S <br />PROJECT ADDRESS <br />OwnerMail Address City <br />Tenant Mail Address City <br />C /A t- I e A:n, �- lid lI <br />Contractor Mail Address <br />��PNum r 6 <br />State License Numb r <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />State/Zip <br />State/Zip <br />State/Zip <br />Contract do of Work <br />Contact Person (Plan Review) <br />I hereby certify that I 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 completed <br />whetherspeclfied herein ornot. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state orlocal 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 and I comply with the State Contractors Lew 18.27 RCW and <br />"r 9nn WAC. <br />REVISED 14(Vr7 <br />Phone <br />Phone <br />Phone <br />FEE <br />�15 . ate <br />PERMIT;* <br />E (30�- q8 <br />