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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.everellwa.org <br /> c F31503-005 <br /> PROJECT ADDRESS 11 <br /> TS�LOrroc-rrf�- p t5�/3'1 ���-(� <br /> Owner Mail Address Cd/ Slale2iT Phone <br /> Tenart Mail Address G Slale0p Phone <br /> �/I�II �J1 INC �/GGa��goat i0/CJyl �.la�l 2S 2el6ca7 <br /> Electrical Contractor Mad Address V City State/Zip Phone <br /> V/yi/c// a Z/Bz Cly ' S-D \ �=> <br /> Stale License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(II residential new construction,remodel or addition) Contact Person/Contact NumberiE ail <br /> 3' <br /> Number of devices(ll low voltage) I [� l <br /> Description of Work to Be Done: ( � ( 'll j of\C�' l Nam <br /> FEE ,\ - <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 500 <br /> 1 hereby certify that I have read and examined this application and know the same to be hue and <br /> correct. All provisions of lows and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting ora permit does not presume to give authority to PERMTf# <br /> violate or cancel the provisions of any other state or local law regulating construction or the EB150 — DOS <br /> performance of construction. That I am authorized by the owner of this property to perform the <br /> work for which application is made and/comply with the State Contractors Law 16.27 RCW and <br /> 296.200 W C—�--- <br /> signature Data <br />