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L <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 <br />PROJECT ADDRESS { <br />Owner Mail Address City State/Zip Phone <br />Tenant ail Address City State/Zip Phone <br />Lip <br />leclri al Contractor Mad Address ity State/Zip Phone <br />g <br />State tense Number �— Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (it low voltage)/n <br />Description of Work to Be Done: C�y LJ ` �7; lJ [/ `' <br />G , C I_ <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 L <br />pedormance of construction. That/ am authorized by the owner of this property to perform the `, 4 <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and 2- <br />296,200 WAC. <br />Zt�ure Datc <br />