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4 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAY. 425-257-8857 — www.everettwa.org <br />PROJECT ADDRESS <br />E1 Lk:g- Fiws . i3u.IdL1M _ P'S20� /t' k A A <br />Owner Mail Address City stateop Phone <br />- <br />Tenant Mail Address City slatemp Phone <br />Electrical Contractor <br />State License Number (required) <br />cse; Use o` Building <br />Address <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (if low voltage) <br />City 5 c,Ct State0p L..1 A- Phone <br />-_-_._ 1�M G <br />City of Everett Business License Number(n�quired) <br />-4 7no <br />Contract Price of Worts <br />Do' A k �� �� v� 6p " vofo -- <br />Contact P rson/Contact Num a /gym <br />Description of Work to Be Done: gf� '� „ nl � C C t 12 ? � <br />Egz- <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have mad and examined this application and know tho same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whother specified herein or not. The granting of a pannji does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which application i9 made and I comply with the State contractors l.aw 18.27 RCW and <br />296.200 WAC <br />REVJSED09W20M <br />FEE -? rC' <br />PERMIT# <br />E i �-) Uq � <br />