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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.everettwa.org <br />` ; C� L� `-� �"ti' S-f ,� <br />PROJECT ADDRESS <br />�.; �I--j� p�{- �✓�,"e-'�`f <br />Owner Mail Address <br />c �� �'' c �= - E✓�,-� �J',->��{-� ,- <br />Tenant Mail Address <br />D �� � ��►'' <br />Electrical Contractor <br />State License Number (required) <br />Proposed Use of Building <br />Mail Address <br />City <br />����l���fi���� ���;�,-f-r-�j <br />City <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done <br />�UI <br />City <br />State/Zip <br />r-- 1 j � <br />►«.�'; <br />State/Zi <br />State/Zip <br />Phone <br />Phone <br />Phone <br />City of Everett Business License Number (required) <br />� %�O� uuU <br />Contract Price of Work <br />Contact Person/Contact Number/Email <br />� �C�v� (�-�'� � /r, c fir� �c=. � r✓lc� � ✓�-�^cF /l [.� �...��' :� �C- <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �� ����� <br />1 hereby certify thaf 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br />violate or cance/ fhe provisions of any other state or local law regulating construction or the ^ <br />performance of construction. That 1 am authorized by the owner of this property to perform the t ��� �.� �� �j <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and � <br />296.200 WAC. <br />1 /� zv 1 � <br />Date <br />REVISED 08/O6/2014 <br />