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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 />PROJECT ADDRESS <br />Ofwn=r Mail Address City Stale/Zip Phone <br />'l/�7CnC� An,'4I TnSctw.,re z�G S1✓ c'f/t%l`�/�� �v'� <br />Slate/Z Phone <br />Tenant Mail Address City / P <br />r%rC E�r6j l l lJ S II L/ �i n�— h, �hc /� `" ` e 33 <br />Electrical Contractor Mail Address city^ State/Zip Phone <br />E/11C EG2 * G Z ? J #/, hoG <br />Stale /�License Number Contract Price of Work <br />C�f1C � <br />Proposed Use of Building Contact Person (Plan Review) <br />Square Footage (If residentia! new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done(G <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I heteby certify that I have read and examined this application and know the same to be true and <br />corre:t. All provisions of laws 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 the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which pplicatfen is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.20�0 W,j <br />REVISEDW0113 <br />FEE <br />�0 5U <br />PERMIT# <br />E1310-12- <br />0/p?L <br />