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a 1 wiz <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERE 1 , VVA 98201 <br />425-257-8810 - FAX 425.257-8857 —vw everethua.org <br />I <br />%e <br />E1503-a�� <br />,6431�P <br />PROJECT ADDRESS <br />n <br />Phone <br />Mad Adtlres5 cityI <br />atc/Zip <br />i <br />r <br />Tenant Mail Address C'ly <br />Slale2,p <br />Phone <br />Arts �A <br />Electrical Contractor mall AdWesS City I <br />Staietzip <br />Phone <br />Slate License Number (requited) <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />l <br />Number of devices (If low voltage) <br />A <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 have read and examined this application and know the se <br />correct. All provisions of laws and ordinances governing this type of work will 1 <br />whether spocified herein or not. The granting of a permit does not presume to <br />violate or cancel the provisions of any other state or local law regulating consh <br />performance of construction. That 1 am authorized by the owner of this proper <br />we-. for which application is made and I comply with the State Contractors Lai <br />298.200 WAC \ <br />I \A. 0, A 0 i <br />Rer.se00sosm14 <br />City of Everett Business License Number (required) <br />Contract pnce of Work <br />4R.m 46ot113�°1D <br />Contact PersonlContact Number/[mail <br />FEE <br />(503` a�a <br />ie to be true and — — <br />completed <br />iv! authontyto PERMIT# <br />to perform the t U `� <br />18.27RCWand--- <br />