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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 /> 89.2 C04 ek <br /> PROJECT ADDRESS pp <br /> i:-X A00 &n ,2G2� <br /> Owner ) Mail Address City State/Zip Phone <br /> �- 291&7y /V U/? <br /> Tenant Mail Address City State/Zip Phone <br /> Alf <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> R'9t2;zE�k ca: /, � <br /> 035-/10 <br /> Li <br /> State cense Number(required) City of Everett Business License Number(required) <br /> LC&'rA4 /z& 2f- <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> J <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 O <br /> I 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 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 pr fs s of any other state or local law regulating construction or the <br /> performance of con uction. That 1 uthorized by the owner of this property to perform the Lf O <br /> work for which ap ation is ad an comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ignature Date <br /> REVISED 08/06/2014 <br />