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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 /> PROJECT lADDRESS c� <br /> r <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> '�El-c '6:lvo�"(�- "/,)Pz- 4 &'�Zf 7-� <br /> Electrical Contractor Mail Address City P State/Zip Phone <br /> va) <br /> State License Number(required) City of Everett Business License Number(required) <br /> m <br /> >. r— <br /> Proposed Use of Building Contract Price of Work <br /> 4;�C. zih 4/L/ <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) / <br /> Description of Work to Be Done: ��C %�� .� ���'( <: 3 fio✓ �i Ct�Y/�i io��5 C��7c1� �-c�cZ1 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 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 goveming 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 <br /> performance of construction. That I am authorized by the owner of this property to perform the E <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> i <br /> Signat Date <br /> REVISED 08/06/2014 <br />