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• 0 <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 /> ejz 'i2.,1(4.3 <br /> 3 0 6 `3 W Lc. .D;... ✓'�.vl tt 6—. a 13U-3 G <br /> PROJECT ADDRESS <br /> LUzre*4- r3ve;,.� <br /> Owner Mail Address City State/Zip Phone <br /> L(c) 2- <br /> Tenant <br /> Tenant Mail Address City State/Zip Phone <br /> Electricaf Contractor Mail Address City State/Zip Phone <br /> • <br /> 5 c . C.> L 91-75-ci LI04 iS <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> 2u.s.k y A...�✓-sc, <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> 2-c)G I53 50 0 L <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: f 6;,J c- -.\---(-> A-4-‘,` 5i-4 i,-,. A r--i---- <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 21 (p S <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 I l 7 __ <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> f j) 1111(1 <br /> Signature Date <br /> REVISED 08/06/2014 <br />