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ELEC'm RICAL 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 /> 64 ?D, '"k Zo <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> eb &X � tsv--LA�'D L-j 1),, "I v 0 0 3 Z--'o 1 -1, <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> C�P f�lqnit'oNjts .41 <br /> Proposed Use of Building Contract Price of Work <br /> 17 T G-Ug.(4,1Q 0 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: t.-.)'4&ZAy <br /> GA i) (l-Q'I 1 'T-1 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE 13 3105 <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 <br /> 13 <br /> performance of construction. That/am authorized by the owner of this property to perform the E <br /> work for which application is made and l comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature <br /> Date <br /> REVISED 0810612014 <br />