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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 />C( 0q -as-2� <br />PROJECT ADDRESS <br />U-z {�a2-rt I �J J�f4L=fr 902n3 gZ!�'-231- <br />Owner Marl Address Cay StatelZip Phone <br />Tenant Mail Address City SlatelZlp Phone <br />PO PYA540 T- WL706 � 3n z391 <br />Electrical Contractor Mail Address City State/Zip Phone <br />State License Number <br />Proposed Use of Building <br />Square Footage (If residential new construction, rem:del or addition) <br />Number of devices (If low voltage) <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: I — Ac 1 Tli-& C(1 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I 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 heroin or not. The granting of permit does not presume to give authority to <br />violate or cancel the provisions of any other state or locallavr regulating construction or the <br />performance ofconstruction. That I am authorized by the owner of this property to perform the <br />work for which aid is lion is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200WAC. <br />FEE <br />r0d2 <br />PERMFT# <br />E ►gofl—osa <br />