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I <br />ELECTRICAL PERMIT APPLICATION <br />PROJECT ADDRESS <br />Owner <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 />L2 -Z <br />vv G 14a s--1ud <br />Mail Address <br />Mail Address <br />Electrical Contractok Mail Address <br />Slate License Number <br />C6mmm,'4 <br />Proposed Use of Building <br />Cay <br />Slate1hp Phone <br />city Slateo, Phone <br />LL <br />Sr ...sl A ( _ . _ 1 nn..., r (2 1) <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (II low voltage) <br />City State/Zip Phone <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: _ �� 20 V <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this appiicarron and Anow the some to be true and <br />correct. All provisions of laws and ordinances goveming this type of work will be completed <br />whether specified herein or not. The granting of permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <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 I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />S- 2�1-- <br />FEE <br />849101 <br />0 <br />PERMIT// <br />E ► L05 -100 <br />