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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 4 _I t--)3 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />PROJECT ADDRESS <br />/ ..it/^ <br />s 1fA i CUB S�� 'h StatelZip Phone <br />Owner Mail Addrese City <br />'05-•971 -/901 <br />Tenant <br />Mail Address City SlatelLip Phone <br />Electrical Cn actor <br />Mail Address City Statelzip Phone <br />-z ,o Te/,1 1 <br />Contract Price of Work <br />State License Number <br />Proposed Use of Build g Contact Person (Plan Review) <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If lov.- voltage) <br />Description of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby codify that 1 have read and examined this application and know file same to be tnre and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granling of a permit does not presume to give authority to <br />violate or cancel file provisions of any other state or local law regulating construction or the <br />perforrnanco 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 will? the State Contractors Law 18.21 ""W and <br />296.200 WAC. <br />FEE <br />-7 0 <br />PERMIT# <br />E 150 r-1 - 033 <br />REVISEDYM13 <br />