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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 />613�o-ice <br />J <br />PROJECT ADDRESS <br />�� S�,t,�u�� Wy��1�� v�D.. 3y�xh ,S� �.vice,�'e �,•�.� �tl�)13\3�0 <br />Owner J103JAddress City State/Zip Phony <br />Tenant Mail Address City Stale/Zip Phone <br />v�l-5 <br />� �\��a��Lo ����� � �D�v1;,1,,,�� 2�-3����v�. ti�� �a� s�ti.;t�� w���a ��•��ti�� <br />Electrical Contractor Mail Address City State/Zip Phone <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person Ian Review) <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: ,W�(� `'�1 �i ! Q� h� L' ` C i �t p� V✓ —�" l� <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 - 5 0 <br />1 hereby codify that I have mad and examined this application and know the sarne to be true and <br />correct. All provisions of laws and ordinances goveming this type of work wall 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 slate or local law regulating construction or the r `� O <br />performance of construction. That/ am authorized by the owner of this property to perform the t <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />--� Y) 2� <br />nature Date <br />HE NSEO! W13 <br />