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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—vnvw.everettwa.org <br />C If3o-7-11 <br />�76)� R1 <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />City <br />State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />� Alt (el /; 17-c r6LLjX 133ao 8A, lam/rT /}liel �/Y t$ g-7 %� ti3 17 <br />Electrical Contractor Mail Ad ress Cily� St a /Zip 9�O/� Phone <br />Alt:l/ ✓tort'' t <br />IA/�/TED Cl 9S1 %�T �/ boo <br />Stale 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) {y'� <br />Description of Work to Be Done <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />i S711176 � ��C%/ �g1 S <br />I hereby certify that 1 have read and examined this application and know the same to be hue and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether spectried herein or not. The granting of a permit 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 />performance of construction. That I am authorized by the owner or this property to perform the <br />work for which application is ado and complyy�Ih the State Contractors Law 18.27 RC W and <br />296.200 WA C_ ��/ I/ / <br />/f / 3 <br />FEE <br />--15 00 <br />PERMIT# <br />E I -30-7-08Z <br />REVISED.YtalO <br />