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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICE� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> �'�� �,/�s�E"/�' ,�,� �� <br /> PROJECT ADDRESS <br /> �:���,��-��`�r,���;�i�t�UT�'�,�'/�% �-��'��,C� �''���',� ��'��!'�'"s �!%/ri' ��'���� ,%�� i���z <br /> Owner Mail Address City State/Zip Phone <br /> ��//�/�� `��l�l. <br /> Tenant Mail Address City State/Zip Phone <br /> - ����,�J y1��.ir <br /> Electrical Contractor Mail Address City State/Zip ;�hone <br /> i <br /> State License Number(required) City of Everett Business License Number(required) <br /> �'�`—"�" � `'� ��� <br /> � � , <br /> � <br /> Proposed Use of Buildir�g Contract Price of Work �,r p� <br /> � �. <br /> ��!!,��.�f���7 L S�C���C.��%� <br /> ���� .5�� �T ,e'�,i✓�+et'��t/!-f',.�: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--' r <br /> Description of Work to E3e�one: ��✓�(.�'��� ����� ��jj{��(����� l�� <br /> ����� %' ��,�� <br /> FEE <br /> CITY OF EVERETT LOC�4L SALES TAX CODE IS 3105 i- ,r-'-� <br /> �)�' . <br /> 1 hereby certify that!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 provi.sions of any other state or local law regulating construction or the � <br /> performance of construction. Thaf I am authorized by the owner of this property to perform the E ��� � — �� r � <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 A�. <br /> � r <br /> � ��; ���A <br /> � Sig• tur Date <br /> REVISED 08/O6/2014 <br />