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ELECTRICAL PERII�IIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES n <br />3200 CEDAR STREET, EVERETT, WA 98201 �`� r� y <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org �� C� p'� �p�/ <br />�-J�1 �t= �v��� (Y�a►► �ay m-J <br />PROJECTADDRESS <br />Owne� <br />Forrrnrs <br />Tenant <br />3�r S�r � <br />Eleclrical Contractor <br />�1aii Address <br />Mail Address <br />��� � rEzi2 , <br />�Brso�# °i4� <br />Slate License Number <br />Mail Address <br />�' 1A� �gIA�'1 <br />Proposed Use of f3uildi <br />Square Footage (If residential new conslruclion, remodel or addition) <br />Number o( devices (II low vollage) <br />Oes�:riptian o( Work to �e Done: <br />CITY OF EVERETT LOCA� SALES TAX CODE IS 3105 <br />Ciry <br />Cily <br />City <br />StatclZip <br />E,�r�� i�A �9z08 <br />Statc/Zip <br />� �zsy m,�l Cr�� wP aeo�z <br />'— StatelZip <br />d� <br />CoMracl Price of Work <br />Phonc <br />Phone <br />15.3�C1 <br />Fhone <br />�nK� ��� � — <br />Conlact Person (Plan Review) <br />1 hereby cerfily fhaf 1 have read and examined this application and know (he same !o be We and <br />correct. All provisions ollaws and ottlinances goveming fhis fype ol work �vill be comple(ed <br />whefherspecilied herein ornoL The grenfing o(a pe�mif does not presumc to give aulhonty(o <br />violate or cancel fhe provisions ol any other s(afe or local la�v regulafing consfruction or Ihe <br />perlormance ol consfrucfion. That / am au(honzed 6y fhe ownerof this prope�ty lo per(orm Ihe <br />work (or which application is made and 1 compty wifh fhe Stafe Confracfois Law iB.27 RCW and <br />FEE � � <br />PERMTf# <br />E (��� DS( <br />