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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 />PROJECTADDR SS <br />Owner MailAddress City State/Zip Phone <br />Tenant MailAddress City / StatelZip Phone <br />/ /,, <br />Electrical Contractor MailAddress Cily Slate/Zip Phone <br />—�g <br />cl-z'4 Z-�31X9 <br />Slate License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />/ goe <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If tow voltage) <br />Description of Work to Be Done: <br />FEE' <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ! qD 7 — I <br />1 hereby certify that/ have read and examined this application and know the same to be true nd 1 <br />correct. All provisions of laws and ordinances goveming this type of work will be completed <br />whethersperified herein or not. The granting of a permit does not presume to give authority t PERMIT'# <br />violate orcanc aprow .sionsofany otherstateorlocal law regulating construction orthe E Crx_;'f,'1 peAormanc of co rruc(ion.. Tlra au,/the owner of this property toperform th/ <br />work for w ich app cation e 1 co I the State Contractors Law 16.27 RCW and <br />296.2C0 AC. <br />Signature Dare <br />