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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 — %^rrvw.everettvaa org <br />C I vo 5- a I <br />a�Io l'sM,lr\j�- <br />PROJECTADDRESS <br />Owner <br />Mail Address <br />Cdi <br />V,-,) OA- gD,11S- <br />Stalelzip Phone <br />cal` 14).s-;39-`}oaJl <br />Tenant Mail Address <br />City Slatelzip Phone <br />Y City S10te2ip Phone <br />Electrical Contractor Mad Address <br />Contract Price of Work <br />Slate License Number <br />Contact Person (Plan Review) <br />Proposed Use of Building <br />Square Footage (11 residential new conslruclion, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: (J���� ✓� U \ <br />CITY OF EVERET r LOCAL SALES TAX COEF IS 5105 <br />FEE <br />1 hereby certify that I hove read and examined this application and knew the same to be true and -- <br />correct. All provisions of laws and ordinances governing this type cf work will be comptoted <br />whetherspeciried herein or not. The granting of permit does not presume to give authority to ri <br />Nviolate or cancel the provisions of any other state orlocal law regulating construction or the L-r5 ^performanceofconstruction. That I am authorized by the owner ofthis property to perform theTwork for which application is made and 1 comply with the Slate Contractors Law 16.27 RCW and _- <br />296.200 W9C. � / <br />Signatu / Date <br />t <br />