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ELECTRICAL PERMIT APPILICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857— t4.,'r-v i�; -jjq'�) '/ <br /> 9 <br /> PROJECT ADDRESS <br /> Owner <br /> Mail Address City State/Zip Phone <br /> Q <br /> Tenant Mail Address City State/Zip Phone <br /> VZZ-2c <br /> Electrical Contractor <br /> Mail Address City State/Zip Phone <br /> 1A, <br /> State License Number(required) City of Everett Business License Number(required) <br /> U� <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage (if residential new construction, remodel or additioni1i 7� 1\11-Ij L-I,,V- <br /> ) <br /> Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: — cc�s rk e-n& /Av f'J <br /> Cites <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> J <br /> hereby certify that 1 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 e <br /> performance of construction. That/am authorized by the owner of ai 1 h <br /> this property to perform the EP 163=W 22- <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ----T— 'P <br /> Signature <br /> ti Date <br /> REVISED 0610612014 -T6 <br />