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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERET7, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />33 � 7 n/a ss� u S�• <br />PROJECTADDRESS <br />Tenant <br />�e� <br />Electrical Coniractor <br />State License Number <br />Proposed Use oi Duilding <br />Mail Address <br />Mail Address <br />Mail Address <br />Po (3sX ����►o <br />Square Footage (If residenlial new conslruction, remodel or addition) <br />Number o( devices Qf low voltage) <br />Description ot Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />Cily <br />City <br />o re. <br />Slate2ip <br />SlatelZip <br />StatelZip <br />Conlract Price of Work <br />Contact Person (Plan Review) <br />1 here6y cerfily fhaf 1 h�ve read and examined this applicafion and know fhe same fo be lruc artd <br />corrrcL �II provisions o( laws and ortiinances goveming fhis type ol work will be cornpfeled <br />whefher specificd herein ornoL The granfing o/ a pr.rmif docs not presume fo give aufhonty to <br />viola(e orcancel fhe provisions ol arry ofher s(atr. orlocal law regulaling consl�uclion or fhe <br />peilonnanr.e o/ consfn�ction. Thaf 1 am authonzed by fhe owner ollhis properiy (o peilonn fhe <br />�vork lor whicfr applicafion is rnade and 1 comply wdh Ihe Slafe Conliacfors Law 18.27 RCW and <br />296.200 Ws�C. n <br />vrv�sro.u.�au <br />�i�yi� <br />� -�lv-o y� <br />Phone <br />Phone <br />Phone <br />FE[ <br />5c-�o <br />L. <br />PERMITll <br />E l`��clo-��� <br />