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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 />C1 3zl-" 54- <br />A - <br />_i�I <br />PROJECT ADDRESS <br />Zee $ Lil- U <br />j�o'/Add VL) <br />MZ73 ©tyiMP,t <br />WeU) DC <br />Owner <br />Mail Address <br />City <br />Slate?ip Phone <br />� (�_ <br />9rt�'� <br />Tenant <br />Mail Address <br />City <br />State/Zip Phone <br />?d / A C, tiN ti <br />Electrical Contractor <br />Mail Address <br />City <br />State/Zip Phone <br />State License Number <br />Contract Price of Work <br />Proposed Usa of Building <br />Contact Person (Plan Review) <br />Z 760 <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) p � <br />Description of Work to Be Done: 24L Aw p.. Poke / ~ Z0 14W P <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 <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 perfo m the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />FEE <br />75� <br />PERMIT# <br />REVISED 3120113 <br />