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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES s _-7_1-3 <br />3200 CEDAR STREET, EVERETT, WA 98201 Eir v,5-0 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />u)e�—c��2 <br />Uf <br />PROJECT ADDRESS <br />Owner <br />Men Address <br />City <br />State/Lip <br />n wm,a <br />Tenant <br />Mail Address City StalelZip Phone <br />lcetl 6c*PIS, K` ck <br />Ductrical Contractor Mail Address <br />City State/Zip Phone <br />_ —t 2 500 <br />C, - L OiA —7 Contract Price of Work <br />State License Number <br />Contact Person (Plan Review) <br />Proposed Use of Building <br />Square Footage (II residential new construction, remodel or addition) <br />Number of devices (if low voltage) <br />1 \ <br />Description of Work to Be Done: <br />-),; 4.1ho.,, e <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hemby 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 goven.ing this type of work will be completed <br />whether specifiod herela or not. The granting of a 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 />performanco of construction. That I am authorized by the owner of this property to perform the <br />work for which applicafion is made and I comply with the State Contractors Law 18.27 RCW and <br />FEE <br />PERMIT# <br />E l'7c` -13 <br />