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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 (,tea 8-13 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> rsi3ab-2iz <br /> 'PL- �c LVe�LY1 <br /> PROJECT ADDRESS -123 <br /> laarclr� SPika<< � �°� T8 + PC 5E tl tIL4 9Fr3 10 C1 <br /> 95 <br /> b°weer Mail Address City State/Zip Phone <br /> Tenant Mail Address City Statep Phoria <br /> qzs <br /> ,� tltCIIL ;Ve) S� P�-c- ?eYssv/ <br /> Electrical Contractor Mall Address City ?State/Zip Phone <br /> (-1�2!-► ter �� 3'3 q <br /> Z ` — o0 <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction,remodel or addition) <br /> Number of devices(If low voltage) / 1� 1 n `r / {f�� <br /> Description of Work to Be Done: +n ��1 SUfgQ {foie,/ gDA Z D V <br /> FEE ,�.��--�� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 (/J� Cry <br /> I huroby certify that I have read and examined this application and know the some to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whother specified herein or not. The granting of a permit does not presume to give authority to PERMrF# <br /> violate or cancel the provisions of any other state or local low regulating construction or 1110 �I <br /> potformmlce Of construction. TI t I nm authorized by the owner of this property to perform the E <br /> work for whirh applicatio is a nd/comply with the State Contractors Law 18.27 RCW and <br /> 295.20 <br /> It <br /> Si at Dala <br /> REVISED"W13 <br />