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• ! <br />ELECTF',ICAL PERIVeIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />/ � <br />/� �b'���5 /I <br />� b �'� 8 �.�-ZC' 1�V2 �D � Av�t <br />PROJECT ADDI2ESS �:J� l S <br />Owner <br />Tenant <br />Electrical Contrar.tor <br />st.. � �i� <br />� Mail Address <br />� <br />MailAtldress <br />-ee`�61 L J�F� <br />Mail Address <br />C}�-AEI-�L�-7�0 � <br />State License Number (required) <br />51- fZ <br />Use of Building <br />n� <br />Square Footage Qf �esidential new conslruction, remodel or addilion) <br />h� <br />Number of devices (If low voltage) <br />Description of Work to De Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />Cily <br />City <br />City <br />SlatelZip <br />Slate/Zip <br />• �a <br />StatelZio <br />20��1Z <br />Phone <br />Phone <br />Phone <br />Ciry ot Everett Business License Number (required) <br />�l�„'r `.' °o <br />Conlrad Price of Work <br />Contact PersonlContacl Number/[maii <br />1 heroby certi(y (haf 1 have read and examined fhis applrcation and know fhe same to be (n�e and <br />correct. All provisions olla�vs and ordinances goveming this fype ol �vork �vill be completed <br />�vhether specifred herein ornoL The granting ol a permrf does nof presume fo give aufhonty fo <br />violafe or cancel (he provisions olany ofher sla(e or local la�v regulafing construction or fhe <br />peAom�ance ol construction. That 1 am authonzed by the ow�ner ol fhis property to peAonn fhe <br />work lor which applicafion is made and I comply wiUi fhe Sfate Contractors Law 1827 RCW and <br />296.200 WAC._ <br />aevis=_o oeme�o ra <br />� <br />FEE <br />75� <br />PERMIT# <br />E (5�� - 00�- <br />