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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 -7 _11-13 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />C r3a-7-Oy/ <br />'. � 0 4 sc.e rl , C, <br />PROJECT ADDRESS <br />I�l0n tie e rA ('l0k-o �s (Cite �LvuRr LW <br />Owner Mail Address City State/Zip 1�10> Phone <br />V <br />Tenant Mail Address City Slate/Zip Phone <br />WTrin'c / 4 n4-, (-( <br />Electrical Contractor Mail Address City Slate/Zip Phone <br />C <br />�o� <br />State License Number vv oContract Price of W <br />i <br />n I a. <br />Proposed Use of Building <br />Square Foolag`e (f residential new construction, remodel or addition) <br />Number of device • (If low voltage) <br />Description of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contact Person (Plan Review) <br />1 hereby certify that I have read and examined this a licafion and know the same to be true and <br />correct. All provisions of laws and ordinane" vemft this type of work will be completed <br />whether specirled herein or not. The gre n of a permit does not presume to give authority to <br />violate or cancel the provisions of any o erstate or local law regulating construction ur the <br />performance of constructio . That 1 a authorized,b tho owner of this property to perfo m the <br />work for which applicafi is lade an I comply with :he State C017traCtOrS Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />t <br />IT#c��1—OLD <br />OCl/I�FII '!/'lNl l <br />