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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 /> 33oz / S"- <br /> PROJECT ADD7SS <br /> Zt��tur s}�f1/VD <br /> Owner Mail Address City State/Zip Phone <br /> V-oR 14-I`AlA7/'V' <br /> Tenant n Mail Address City State/Zip Phone <br /> LCL E��y� Coi,, `lam <br /> /4/-o l1S/ <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> �a <br /> Proposed Use of Building Contract Price of Work &Zfj <br /> L?— <br /> DAY 10 <br /> AZAe-"u 9-,,,6P–PC- <br /> Square <br /> G� <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) p� � <br /> Description of Work to Be Done: > //cf-'—j ,!/A� p <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 i � �] <br /> /hereby certify that/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 O�� <br /> performance of construction. That/am authorized by the owner of this property to perform the I ,50�o <br /> work for which application is made and l comply with the State Contractors Law 18.27 RCW and <br /> 296.200/WRAC.. <br /> Signature D to <br /> REVISED 0@/0fi2014 <br />