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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 /> Qt:O of"' ) 8S30 E-qo?W-93'j u;0 fyLa1✓TT , �A - 18 08 <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> —VT-S 70 S S� C LOA n1 P- i_A t G W L';P�o GQ %97c j <br /> Electrical Contractor Mail Address City StateJ/Zip Phone <br /> A Ps' 6C r-O <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> q cam, BULL- 8c%-- <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: (el!LL r6u EQ A'tj)' Cat CPA i NS TPt t 1A (I z1('j Gt <br /> q ftjf L� (Ac,C k-f f . <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 C2000 <br /> 1 hereby certify that I 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 cancel the 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 E (c)76 Z <br /> work for which application is made and/comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Date <br /> REVISED 08/06/2014 <br />