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ELECTRICAL PERMIT LI A I <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 /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Co tractor N461 Address City State/Zip Phone <br /> I:-- u t_2 o 4/( G C 3 cam' <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: ­1 12�1 cl_ ` S C �� 6-0 i 2�1 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ,5 D 01) <br /> I hereby certify that l 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 law regulating construction or the �O r <br /> performance of construction. That I am authorized by the owner of this property to perform the f <br /> work for which application is made and/comply with the State Contractors Law 18.27 RCW and <br /> 29ZWA C. <br /> S - Date <br />