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ELECTRICAL i''ERMI i' APPLIGATION <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 />�JSo S�I <br />Q_2D—IS <br />PROJECT ADDRESS <br />Owner Mao Address city StateRip Phone <br />�ZS �836s�� <br />Tenant Mall Address City State/Zip Phone <br />Electrical Contractor Mail Address city State/Zip Phone <br />QGQKlE2. <br />Slate 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/Conlact Number/[mail <br />S1B0 <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 i1r) (/ / 1 00 <br />I hereby certify that 1 have read and examined this application and know the same to be true and -- <br />correctAll provisions of laws and ordinances governing this typo of work will ba 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 low regulatingconsfmctionorfho I_ �� <br />performance of construction. That I am authorized by the owner of this property to perform fho <br />work for which application Is made and I comply with the State Contractors Law 16.27 RCW and <br />296.200 WAC. <br />!___ <br />7ffo <br />pcwscnososaora <br />