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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 S J)3 <br />3 I&7v/' Af W Ci3ny��6y <br />PROJECT ADDRESS <br />rorf1a,r f slY -- <br />Owner Mad Address City State/Zip Phone <br />Tenant Mail Address City StalelZip Phone <br />,C 73/ 2S- s� <br />Electrical Contractor Mad Address City State/Zip Phone <br />rit /ifl 03`li--q �fSpo J:2::, <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Se(-Vl <br />1 hereby certify that 1 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 oulhonty to <br />violate or cancel the provisions of any other slate or local law regulating consbuction or the <br />perrormanco of construction. That I am authorized by the owner of this property top the <br />work for which application is made and 1 comply with the State Contractors Low 18.27 RCW and <br />296.200 WAC, <br />FEE <br />-7 5°0 <br />rE30-(��{ <br />Re VISEO.wau <br />