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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 /> PROJECT ADDRESS <br /> Owner `� �1� 'J�f• "Zy <br /> �ailAdr*eEis City State/Zip Phone <br /> Tenant Mail Address <br /> City State/Zip Phone <br /> �Electric�aiCont�rs-to Mail Address <br /> � � City State/Zip Phone <br /> State License Number(requir,ed OQ <br /> City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> �to �� ►-,._�aoc� .�� . RSI <br /> Square Footage(If residential new Construction, remodel or addition) Contact Person/Contact tVumber/Email M <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: _—lib <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE 15 3105 <br /> I hereby certify that/have read and examined this application and know the same to be true and 4 <br /> correct. All provisions of laws and ordinances governing this type of work w411 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 provislons of any other stats or local law regulating construction or the <br /> performance of construction. chat/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 98.27 RCW and <br /> ,'.200 WAC. <br /> Signature <br /> Date <br /> REWS,-0 0&06ao 14 <br />