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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 425-257-8657 – www.everettwa.org <br />� � � , . � <br />PROJECT ADDRESS <br />� I i- � i� i <br />Own?r <br />Tenanl <br />��. � . - - �- <br />Electrical Contiactor <br />� � �. . <br />Mad �ddress <br />Mad �ddress <br />��__—__� <br />Mail Address <br />t� <br />_ �. ',i,,/, <br />(;ity <br />City <br />y ;f.,r�� �1 �'� <br />City <br />'�C' U.' 1< E K` I� 1 l� ` - <br />State License Number <br />. ��, i i�e�';�• _ <br />Proposed Use ol Uwlding <br />.� _� �� � <br />Square Footage (II residential new construction, remodel or adddion) <br />Num�er ol devices (If low vollage) <br />Descriplion o1 Work to Be Done � <br />� <br />Slate2ip <br />Stale2ip <br />Stale�Lp <br />Phone II <br />Phane I <br />I <br />z`iC� (atS)4S1/�S yC� <br />Phone I <br />� � � C�' l %. C C� <br />Contrad Price ol Work <br />Contact Person (Plan Review) <br />US'� _ <br />- — -- � <br />FEE \ � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 Gio�) I <br />1 hmchy cr.�hly Ihaf 1 have rend nnd exarrrined this applica6un and hno�v (he same lo be fn�e and I _ ; <br />coiiecf. All provisions allmvs nnd o�dinancr.s goeeming flris type ol �roilr u'ill bo contplefed I <br />�vhelhcr speciGed hr,min or nof. The �rnnfing o/ a pcnnil Aocs nof proswne to gico aufhority tn PERMIT« <br />violnte or cnncel the provisions ol any ofhersfafe or locallaw iagulafing constnictron or fho �.� _ G. � � <br />perlonnnnce o/ consfnicfiorr. Thaf I �' � �ufhorized by the owner o/fhis property fo pe�fonn fhe E�;`�; 7- ��_ �'- � <br />n�o�k lor which npp6cation is niaiic and I comply wifh fhc Sfnte Confrac(ors Lmv 1827 RCW and <br />296200W�C ./ . " <br />i>^ / <br />,� ��_,-,-_ . ; �'/�1 � i 3 <br />