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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 /> ��� �� / ��E:i�z���./f y � ���7 7C-��j j=L�G�c' ��ivc j� <br /> PROJECT ADDRESS ��G"% �� �`� <br /> J - - �/�,� / <br /> �;,.� /_�/i l <z-;;✓ . ����J��- ,/7 :� ./Iz=t�Y �l��; ,;Z��"' <br /> „� � � ,�� <br /> OWnef Mail Address City State/Zip Phone <br /> , <br /> ,. _ , ; __ , ., <br /> _ <br /> . <br /> � i.. l_ C_ j/iY< �c �/s /�i 7t �-� `� ;� • "/ _; . J�r � <br /> Tenant Mail Address City State/Zip Phone <br /> ���::f� i 1>'t L ��✓1�L1�>;C i r-; �o:f%>1�,.„`c �;/, e�i. /��� �%C !i� G:.:%� f�=��-!Ll �C�� $�i >���' <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> /���'v -� i7/ �% � �> 7 ''� (� � <br /> � / /Gi <br /> State License Number(required) City of Everett Business License Number(required) <br /> J�i j�°� T> f"� s, _� i i%ic�r- i i/i� .,:�'� i� �,;i<.� '",�`',, �'c�= c'�'C. <br /> Proposed Use of Building Contract Price of Work <br /> .�'�-%�:�_"� >>JN� <<-•�. <br /> �� C�'C i%���L f.�.t'j�'�%�-. /l`_ i7G �`//i' i <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> -, <br /> /�= � <br /> Description of Work to Be Done: ���f•�-%c� ,,y �-� z �� �z.i i�'�d����� —d` ���f'� . S �i ���.��'� %��°%����-z�� � <br /> � <br /> �G� � Gf��fiia Y� �/vGs�! j.� � �_ �� ��� ,it/�yt-%� �i5�✓-�.�/-��✓',�'�t_�� <br /> i% � f Gy.�" v7 Gi�_ .•- <br /> �l- i.> - �'i� .�.K. Li ���!/ jt���>`- �!'%7"� %_i�i//✓�'-=c" r�L iJ�_ /�-'s'v���L�s <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �� C� �� <br /> I hereby certify fhat 1 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 sfate or local law regulating construction or the � �� � , i � f � /���/' <br /> performance of construction. That 1 am authorized by the owner of this property to perform the �-� � (� (� <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �y ��iY'�-___ �%��/1�_.��� <br /> Signature Date <br /> REVISED 08/06/2014 <br />