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09121/2016 11: 07 136075738 FEDEX OFFICE PAGE 01/01 <br /> 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 ADDgESS <br /> Owner Mail Address City State0p Ph ne <br /> (36o)2z - <br /> Tenant Mail Address <br /> city State2lp Phone <br /> 0l,C� <br /> Electrical Contractor Mail Address city State/Zip Phone <br /> State License !Number(required) City of Everett Business License Number(required) <br /> Propose se o Building Contract Price of W k <br /> 60) <br /> Square Footage(If residential new construction,remodel or addition y <br /> ) Contact Person/Contact Number/ mail <br /> Number of devices(if low voltaga) ."� '�' <br /> Description of Work to Be Done; P11 ' <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> horeby cortify that I have read and examined this spplication and know the same to be true and U <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 <br /> performance of construction_ That tam authorized by the owner of this property to perform the `��� l <br /> work for which application is made and l comply with the State Contractors Law 70 fo and <br /> 296.200 WAC. <br /> Date <br /> REVISED 001%2014 <br />