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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 Mail Address City State/Zip <br /> 47-2 -7 E 5 1 <br /> Tenant Maii Address City State/Zip Phone <br /> �jffb4p� tr_ A\IG .4Z5 <br /> 5�7 r- <br /> Electrical Contractor Mail Address City ','tatefZip Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Building <br /> Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) tie <br /> Number of devices(if low voltage) <br /> Description of Work to Be Done: 4 <br /> lninv--na -Lkrcw <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br /> I 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 pen-nit does nOtprestirne to give authority to PERMrT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction, That I am authorized by the owner of this property to perform tare E13 <br /> work for which application is inade and/comply with the State Contractors Law 98.27 RCW and <br /> 71 296.200 W, <br /> �p< 5, ;2-,-)-, 17 <br /> Signa ure Date <br /> REVISED N20113 <br /> ........... <br />