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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 />ILI a q-) 2.1-el CO T 5 F- <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />City <br />City <br />Slate/Zip <br />Phone <br />Phone <br />Electrical Contractor Mail Address City State2rp Phone <br />1q<'F teF -T9r4 <br />Stale License Number <br />F I4b <br />Proposed Use of Building <br />yba6Qta6 <br />Square Footage (Iftesi ential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description or Work to Be DoneL? -) c � .2C �� C <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contract Price of Work <br />Contact Person (Plan Review) <br />I hereby certify that I have read and examined this application and know the some to be Irue 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 <br />violate or cancel the provisions of any other state or local low 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 Slate Contractors Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />-75 °'D <br />PERMIT# <br />E1311- v37 <br />REVISED "W13 <br />