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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 />I a-? -7ti4� ST s t✓ <br />PROJECT ADDRESS <br />&ver)y LprdOrnintums 06 <br />Cromer Man Address City StatelZrp Phone <br />Tenant Man Address Cdy SlatelZip Phone <br />eru �'--C'A i W �1 amp ( � 01-e S • CIZ4 "+ 9kU 3"t <br />Electrical Contractor Mail Address Gty state/zip Phone <br />P TQoV,=aP <br />State License Number (required) <br />Proposed Use of Building <br />37gy3 <br />City of Everett Business License Number (required) <br />C3V1l-f <br />Contract Price of Work <br />Square Footage (II residential new construction, remodel or addition) Contact Person/Contact Number/Email <br />Celt a Zo6-ASS 52 63 <br />13 <br />Number of devices (If low voltage) <br />Description of Work to Be Done, 14,60Ce i3ad Fire Pones `Itlte �,f I�ke� <br />CITY OF EVERETT LOCAL SALES TAX CODE 15 7105 <br />I hereby certify that I have read and examined this application and knowfhe 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 <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of nstrud"d That 1 am authorized by the owner of this properfy:o Wform the <br />work for whit a plicabon is made and /comply with the State Contractors Lew 18 27 RCW and <br />296 200 W C <br />1\-al- ►y <br />enasm011xxwl0141 <br />FEE — <br />131a-8'Z <br />PERMIT++ <br />E (fir(-�99 <br />