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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERK41T SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� Fe« Rout <br />PROJECT ADDRESS <br />S�� ke N%VjWt1le wA, q�2�v <br />Owner Mail Address City State/Zip Phone <br />42s-2-70-2419 <br />Tenant Mad Address City State/Lp Phone <br />W xj- ' <br />Electrical Contractor Mail Address City State/Zip Phone <br />State License Number (required) City of Everett Business License Number (required) <br />�� M"o G ii,- E c. -r Qo li,- <br />Proposed Use of Building Contract Price of Work <br />Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br />Number of devices (If low voltage) <br />Description of Work to Be Done I (_--M <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 to ro GD <br />1 hereby certify that I have read and examined this application and know the same to be true and '' �VV <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 // <br />performance of construction. That I am authorized by the owner of this property to perform the E l c 01 — 00(o <br />work for which application is made nd 1 comply with the State Contractors Law 18.27 RCW and <br />296 200 WA C. <br />Si lure" Date <br />REVISEDCPA& V" <br />