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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 — vniyyy.everettwa org <br />1 49 £a Gg Svc <br />PROJECT ADDRESS <br />Owner Mail Address City Stale/Z,p Phone <br />Tenant Mal Address City Slaterzip Phone <br />( ; V %L i� .�r\e- 4� 3 it � 3�o W Pub uT ?4c c� u Phone <br />Electrical Contractor Moil Address City SlateRip Phone <br />Sta a License Number (required) <br />Proposed Use of Building <br />Square Foo'age (If residential new construction, remodel or edditlon) <br />oL6 1( <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />Contact Person/Contact Number/Email <br />Number of devices (If tow voltage) <br />Description of Work to Be Done _emu + vr%� • ' `c{ M ��� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have road and examined this application and know the 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 auth0nly 10 <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which applicati� is madepnr/� comply with (he State Contractors Law 18.27 RCW and <br />296.200 WAG. , // 7 1 <br />FEE <br />l�J pa <br />PER141T8 <br />E e? 150 Z- 03-7 <br />PEWSED oto"I1 <br />