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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 /> 727/ f4,//14"1"- <br /> PROJECT ADDRESS <br /> e--Wer.-77/1/61els/// /4070/// 0,0,e /✓ '7 > %// P2a /.ii. 9az <br /> Owner Mail Address City • State/Zip Phone <br /> f &2fl /ATS. <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> 2 <br /> Proposed Use of Building Contract Price of Work <br /> S—CO rt �c)/✓/VOI E"144//, <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: G10,04/6-&. /'768/7--"7 �j T`�� � 7e3 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 V <br /> c'ro <br /> I hereby certify that I 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 PERM1T# <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 1411 -U2_0 <br /> work for hich application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 _- <br /> Aae <br /> /-.7•70/ <br /> • <br /> Sig,. Date <br /> REVISED 08/06/2014 <br />