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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'L SJ <br /> PROJECT ADDRESS <br /> 1=e-<--eSc\ GU if ci) 7,0 pioz_ tvf q p 2„)y. <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> T.� f. 1.141- S ,)-l0Q W !E /) SI ti w( Li `i 9 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> Rest d.6Psia <br /> Proposed Use of Building Contract Price of Work <br /> Square FootagL(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> � L <br /> Description of Work to Be Done: nJ`W C t vL 01 IR cn. C eV( <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that I have read 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 permit does not presume to give authority to PERMIT# <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 of this property to perform the <br /> work for which application i made and l comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ( <br /> ignature Date <br /> REVISED 08/06/2014 <br />