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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 0 y <br /> E )q/o-017 <br /> PROJECT ADDRESS <br /> ;'e-u 7t0S-k Y/S S ss ry��s� _✓• c% �••�P 9�<0� ri2S IYYlY17 <br /> Owner Mad Address City State2ip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> JSoT a' S� JrS Zy,& . e i✓ /` TOr.243 �Af.55S?k7 <br /> Electrical Contractor MailAddross City State/Zip Phone <br /> DSd'5; xx 0-2,1zfrv2y <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Budding Contract Price of Work <br /> Square Footage(If residential new construction,remodel or addition) Contact PersonfContact NumberfEmail <br /> Number of devices(It low voltage) <br /> Description of Work to Be Done: O[ f �� •� c i '43 i�,_Jr e __ . <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that l have mad and examined this application and know the some to he true and <br /> correct. All provisions of laws and ordinances goveming this type of work will be completed — — - <br /> whether specified herein or not. The granting of a pemnl does riot presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other stale or local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors law 18.27 RCW and <br /> 298.200 WAC. l <br /> /6 - y— <br /> ynatwe onto <br /> REVISED 0606701/ <br />