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ELECTRICAL PERMIT �4PPLICATION <br /> CI�Y OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> .������� � � - <br /> PROSECT ADDRESS <br /> E`l/�,��Ti`�����`i�t1UT�"r'�,�i�/ ���'�,�,(i /✓��'� c��'���i ���/r'.J %�'��1v �s�� i���Z <br /> Owner Mail Address City State/Zip Phone <br /> ,�,��//'���'%��,/ ��/'r'��. <br /> Tenant Mail Address City State/Zip Phone <br /> �� ..� <br /> ��VV�ff� l!' <br /> Electrical Contractor Mail Address City State/Zip ;�hone <br /> State License Number(required) City of Everett Business License Number(required) <br /> �' � ' ��—' ��� <br /> �� � �.? �,: <br /> Proposed Use of Building Contract Price of Work <br /> ��/��-/��i`�� �'S v�L�ci�.J��� <br /> �C�f� ��� � �. �C�j✓01/�`��f�f�,-U�C� <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email I <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: �-�i'�(���j � L���/ ,� ��j��.(`,���� �'� <br /> r�/��.�c� / .s%r`f� <br /> FEE <br /> CITY OF EVERETT LOC�L SALES TAX CODE IS 3105 ����-1 <br /> �,.� �,, -_ <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. Al/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 PERM IT# <br /> violate or cancel the provi.sions of any other state or local!aw regu/ating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the E I(-�-� P �� I �� <br /> work for hich app/ication is made and l comply with the State Contracto�s Law 18.27 RCW and <br /> 296.200 A�. <br /> ��- �=-i� <br /> Sig t� Date <br /> REVISED 08/O6/2014 <br />