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0 <br />Ah <br />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 6 '-)14 3 <br />G13% <br />L�7 <br />PROJECT ADDRESS L�Z� 252 <br />L L( PV1GrLr� 9' 1& 037 <br />Ow e- �'- Mail Address City SlaletZip Phone <br />Tenant Mail Address City Slate/Zip Phone <br />Electrical Contractor Mail Address City Slate/Zip Phone <br />E4f� �r�cl) �o-7 g� <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Square Foutage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) -� / / / ✓� <br />Description of Work to Be Done: 611 � 62 S C%✓1'U f f G 6L 2 Y? � O / <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 5V � <br />I hereby certify Ilia( I have read and examined this application and know the same to be true and �J <br />correct All provisions of laws and ordinances goveming 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 orlocal law regulating construction or the i ^ O l O <br />perfommnce or construction That I am authorized by the owner of this property to pe,aonn the 5 <br />work for which application is or e and I comply with the State Contractors Law 18.27 RCW and <br />29G.200 W <br />Sig at re 1 Dale <br />nEvisee.NX'73 <br />