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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 /> 3zoc> 6zk,, r~e4-w 4 lez 0) <br /> PROJECT ADDRESS ( , r K2S-ZS7--8Y� <br /> cU�j' �/ILJ� 329D fid' WA- (7eLo <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Ne�k,aes-f- `s©✓t I`tSC)4 I `i I9Ly,}r-- 0QQk-,tiA 39 01 Z <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> �� —}'-S k'-.5r-'rvirr- l`i 9esttyy� <br /> Proposed Use of Building Contract Price of Work <br /> �Y[A- ,,. 5 WLS.2 S?-fit`l2 <br /> Square Footage(If residential new construction, remodel or addition) Con ct Person/Contact Number/Email <br /> N(/- <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: �Q.pl`cQa..n.-I" a� s-�-r�' ����,-� (yy►ti�na�rtj �;�y wT�, <br /> ,—kk c; , a ski• 1�.4 ws k� -�a-�^g � -i c�a�. �- L.E D I� :,��.: <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 'V 1,SD, <br /> l 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 permit does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or.local <br /> by <br /> law regulatingproperty ostructi P or the E <br /> performance of construction. That I am authorized b the owner of thisto perform the <br /> work for which application is made and/comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WA . <br /> Stature Date <br /> REVISED 06/06/2014 <br />