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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 /> 9 O' k5 > <br /> PROJECT ADDRESS <br /> / <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone -- <br /> JC// <br /> rp. <br /> Electrical Coritt'actor Mail Address City State/Zip Phone <br /> ,Li4-‘5\i ;93.3 7i Q <br /> State License Number(required) City of Everett Business License Number(required) <br /> ,91 , <br /> Proposed Use of Building Contract Price of Work <br /> Rogi <br /> -7 0e) 1 29/a 36c7 3/ 7 9 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: t>lr/rte—� /�a /7 � i9,-70 <br /> yk ' <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 "1� I <br /> 1 hereby certify that l have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the E 4 Cr7 f c - 16.17 <br /> work for which .•,'.lication is made,; d I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WA r <br /> Signatur / Date <br /> REVISED 06/06/2014 <br />