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ELECTRICAL PERMIT APPLlCATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.evereilwa.org <br />�n ��� ,� LvccP�� ����\����#��� <br />PROJLCT ADDRESS <br />Tenant <br />F <br />Address <br />Mail Address <br />ContfaCtof � Mail Address <br />�T\ r�`�"—�` � '`',211 � <br />Stale License Number <br />Proposed Use of Building <br />Square Fcotage Qf residential new construdion, remodel or addition) <br />N� er of devicas (If low voftage) <br />Description of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />���Y <br />City <br />Ci�y <br />State2ip Phone <br />LVQCe.��.�1.� 1��18��� <br />� 1�, �� � 1 �I :�5 -�l�S -C��l <br />State/Zip Phone <br />d? 63 - <br />State2ip Phone <br />� I '�'1Ci1 C�(� <br />Contract Price of Work <br />�1� <br />Contact Person (Plan Review) <br />I hereby certi(y thaf 1 have read and examined fhis applicalion and know lhe same to be true and <br />wrrect. All provisions o/laws and ordinances goveming this fype olv�ork will be completed <br />whether specified herein or noL The granfing of a permit does not presume to give authonty to <br />violale or cancel the provisions ol any otherstate orlocal law regulating consfruclion or the <br />pedormance of construction. That I am authonzed by Ihe owner o( this property to pedorm the <br />wodc for which application is made and 1 comply wifh the Stafe Contractors Law 18.27 RCW and <br />296.200 WAC. <br />hevisEo.viai3 <br />FEE <br />�OdO <br />PERMIT� <br />E 13 tf - D�oO <br />