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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 />1 <br />PROJECTADDRESS <br />Owner J Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contactor Mail Address City State/Zip Phone <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />/5-U <br />Square Foota a (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Dcne: _ n�ti r L ( 6 r rF <br />F,Ari i-J-111 LA(�1�. L1�ram' <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that 1 have mad 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 pennit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />petformance of construction. That I am authorized by thu owner of this property fo pertonn the <br />work for which application i4 made and I comply with the State Contractors Law! <br />�8.27 RCW and <br />296.200 WAC: - / <br />6l <br />FEE <br />PERMIT# <br />E ' ;3D �5 b0� <br />OF VISEa 3l 01I <br />