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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 /> Zgo!5;- <br /> PROJECT ADDRESS <br /> VaTZ> Ej- <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Gj7—s Z Z— <br /> �l/?rtx�17Fc7G !'O -9�� <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: S�v s/tee, ga-Akl w e,1r46u lTS /bre- La'. 774&e� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 137-50 <br /> /hereby certify that l 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 r <br /> performance of construction. That l am authorized by the owner of this property to perform the t ( [,�7 b -- <br /> work for which application is made and l comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Date <br /> REVISED 08/06/2014 <br />