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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 />carrr, — !— .�.�G �Pi✓Lilcp <br />Owner Mail Address ,2 City 1 Iat'e/Zip �j Phone <br />„� ., etc-,- ti s c1 ��yz-ra�4ei fif I L&I <br />Tenant C MM Address <br />`City State/Zip Phone n <br />Electrical Contractor Mail Address City State/Zip 2 PpopeOr /Z <br />A(reiS <br />Slate License Numb Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <3/ �_ r �Un <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know tire same to be true and <br />correct. 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 PERMIT# <br />violate or cancel the provisions of any other state or local law regulating construction or the r 1 l 0 D �� <br />perfomrance of construction. That 1 am authorized by tire owner of this property to perform the C <br />work for which application is made and I comply with tire State Contractors Law 18.27 RCW and <br />296,200 WAC. <br />Si nature Date <br />REVISED 72dq <br />