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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES ' <br />3200 CEDAR STREET, EVERETT, WA 98201 ;`�V� � �', <br />425-257-8810 - FAX425•257-8857-www.everettwa.org �' - � � !� <br />I" <br />�' ,Ju L � 2��3 �-�� <br />I3�S �-i S� �v'��r��'i� �'�(rFLL <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />S� � <br />Eleclrical Contraetor <br />Mail Address <br />�% S � <br />Mail Address <br />� � £c ,—�: r c �, <br />Mail Adtlress <br />S� L�����ra C��� <br />St2le License Number � <br />Praposed Use of Buildiny � <br />Square Footage Qf residential new construclion, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />Ci�y <br />Slate/Zip <br />State/Zip <br />Phone <br />" 3.�..��� <br />Phone <br />City State2ip 'hone � <br />�5�3-�7� -� � I- <br />, <br />� 36 . c�z, <br />Contracl Price of Work <br />\ <br />�4 i i�1 %�i iL' % U �C. <br />Contact Person (Plan Review) <br />1 hem6y ccrtily lhat 1 have read and e.eamined this applicafion and know the same to be We and <br />conecL All provisions o/ laws and ordinances goveming tlfis fype of v�ork �vi116e completed <br />whefher speci(ed he�ein or noL Tha granting o/ a permit does not presume to give aulhonty fo <br />violate or cancel the provisions o/ any other sfafe or local law regulafing constnrclion or the <br />pedormance olconsWction. That 1 am aufhonzed 6y the ownerol (his property to pedomi the <br />work lor which application is made and I comply wilh the S�afe Contracfors Law 7827 RCW and <br />296.:00 WAC. ) , , , . <br />FEE <br />..�" / � --� <br />,� <br />PERMIT# <br />E��OF'��{-� <br />