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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 - t4/w txr -,e Ile-o'e;`4 L'J4 <br /> X6.44 e. ver-e-'t'-p wea- <br /> PROJECT ADDRESS <br /> R <br /> Owner Mail Address Cit <br /> 1 Y State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Pb f"a X �U0 Int rw-uo D LJ G c. <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> _ 4' 25U <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition <br /> Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: CDsreT1L/ <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE 13 3105 r?o <br /> I hereby certify that l have read and examined this application and know the same to be true and V <br /> correct. Allprovisions of laws and ordinances governing th50 <br /> is type of work will be completed _ <br /> 5 <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 /> n. <br /> d by the owner of <br /> work for which applicatioormance of n is made and/and/cotmplyewith the State Contractors Lawy18.27to �RCW and ` I <br /> 296.200 WAC. I �� <br /> Signature ( I 5 <br /> t Date <br /> REVISED 00/00/2014 r t L 76 1�0 ' <br />