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� <br /> ELECTRICAL PERMIT APPLICAI"ION <br /> CITY OF EV'ERETT PER.MIT SERVICES <br /> 3200 CED�R STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> �� / �%/'�`� :�% <br /> PROSECT ADDRESS <br /> �-���,�'�-Ti`/��✓�%�C�r1�i�`�!'�k'/�� ��'�>,� /✓ ��`�' � C���� <�/rf ��!%c�J�% /y��' i�l�Z <br /> Owner Mail Address City State/Zip Phone <br /> ,..���.�/'��l����-� �/.��/��.� <br /> Tenant Mail Address City State/Zi� Phone <br /> Electrical Contractor Mail Address City State/Zip I�hone <br /> � <br /> State License Number(required) City of Everett Business License Nurnber(required) <br /> ���� _ ' � ���,, �� <br /> Proposed Use of Building Contract Price of Work �/ <br /> ��Or/��,��r�`�� 7�.5 v��c`Sl>.��r� <br /> ����� ��, � � �c�ir///►���G''!�fl_C)/'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 /> ��� S /� A <br /> Description of Work to Be�one: �-�o'�(.���j E" G—s��,� �!j{''�,(`,���--'�� ,��� <br /> r�/���G / �%�f� <br /> FEE <br /> CITY OF EVERETT LOC,4L SALES TAX CODE IS 3105 ��C�� <br /> I hereby certify that 1 have read anJ examined this application and know the same to be true and s <br /> correct. A/l provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. Tiie granting of a permit does not presume to give authority to PERMIT# <br /> violate or cance!the provi.sions of any other state or/ocal law regu/ating construction or the i ) /� <br /> performance of construction. That 1 am authorized By the owner of this property to perform the E J�--� ! / I.JG Z <br /> work for hich application is made and l comply with the Stafe Contractors Law 18.27 RCW and <br /> 296.200 >4�. <br /> * <br /> � ��' ` �� <br /> Sig• tur,. Date <br /> f <br /> REVISED 08/06/2014 <br />