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• • <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 /> ti7;(7 fVer44 (% <br /> PROJECT ADDRESS <br /> 44X& auk/ e.2/ „i ' 5, T /i'e' IfA Y)24 q2(' 2-4' 1!// <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> kGa%dav E/C,f/ic 3 ,f'-t? '124 r/ /t SE 4,2IAix c- t / i3/2,,3c <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> ©/REE 0J5qtt G 5 G <br /> S ate License Number(required) City of Everett Business License Number(required) <br /> �s� 3�� w <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 /> Number of devices (If low voltage) <br /> • <br /> Description of Work to Be Done: //-'c./ 4 //'e <br /> ( 4/i lac L2—i - .r s/ 4 - a�G-�C� ,,<7 ' 4 <br /> 744 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 C`1 <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 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 I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ignature Date <br /> REVISED 08/06/2014 <br />