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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />///D o /Y <br />�nz I � �- xd/ <br />PROJECT ADDRESS <br />le-h aI <br />0� / le// <br />Owner Address City State/Zip Phone <br />Tenant Mail Address City SlatOzo Phone <br />/ <br />Electrical Contractor Mad Address City Sfalelzip Phone <br />Cam,"kZT&-o�le 7 0Dc/) <br />1 92- <br />State license Number Contrad Price of Work <br />�e—sr <br />Proposed Use of Building Contact Person (Plan Review) <br />Footage (If restder�fal new construction, remodel or addition) <br />Number evices (If low voltage) <br />Description of Work to Be Done: eiy"� �C4G <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />t hereby certify that I have read and oxaminrd Misapplication and know file sarne to be tore and <br />correct. All provisions of laws and ordinance,, goventing this lypp, of work will be completed <br />whether sper, d herein or not. The granting of a pemrit does not presurnc to give authonty to <br />violate or noel he provisions of any other state or local law regulating construction or the <br />per{on I nre of nsfmcfio . That 1 mn authorized by the owner of this property toperform the <br />work I which plicatio s m�e and j�FJrl�+ply with the State Contractors Law 18.2.7 RCW and <br />29G.2 0 WAC / ��� <br />Siqnalure Date <br />FEE ---- — — <br />PERM(Ttt <br />E 13��u0153 <br />RE WSED WW 13 <br />