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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 /> ���I �;��.5 �UG <br /> PROJECT ADDRESS t f:�j^.. ��c��L <br /> J c�..n,�e,> ����+�� e�� �l'�i l� ti`� . ��v�� ��� �.z�S-(���s �1� �(8��� <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> ���E1^ <br /> Electrical ContraCtor Mail Address City State/Zip Phone <br /> State License Number(required) City of�verett Business License Number(required) <br /> � � � �� <br /> L�,�.�,����� <br /> Proposed Use of Building Contract Price of Work <br /> � . <br /> —�f�r�e,5 CQU��j Q�*� �.K���<-,��� <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/ContacY umber/Email �y�— � <br /> �l `��il X C}� <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: �nS���1 ��t l `dj(l,�nS CN�� Cl�C�c:��tl�,�,� �����Ci <br /> ���s� ��c�.n� �.�c� ,-�e s'.,�� �l�J 'l�k( � -�4' <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �� �`_'� <br /> i <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correcf. 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 /> perfiormance of construction. That 1 am authorized by the owner of this property to perform the E � �Cj ��' Q� � <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � G�-�� `��.v�-' �((O i S <br /> Signature Date <br /> REVISED 08/O6/2014 <br />