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i . <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—wuvw.everettwa.org <br /> a. 8�3 � � ��/ ��'�, �t��i� , <br /> C-o�� v9�'� ,�r��,���,� � <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> ��2�u ���3 coc..�'y �� ��2'�j"�. �'�} (��l <br /> Tenant Mail Address City State/Zip Phone <br /> I `9C7l�` .3(o�l�cs-e,Cz�, �Suc�--e 1� '��j�77��7406 <br /> ��61 V`� ��.C`�'�'t` C_ e�� l�^,�n .a^ �P ,,I�'-� �-�.i�it��OOc`�J Lx�A� %�� <br /> Electrical Contractor Maii Address City State/Zip Phone <br /> ' l�(l��. L�c=. �,�c�r� l�C� �� I � �� <br /> State License Number(required) Gity of Everett Business License Number(required) <br /> ��L�. ����'9��. � ��� • �- <br /> Proposed Use of Building Contract Price of Work <br /> c����f�os���,'r'�`� r�b`��3=1I <br /> Square Footage(If residential new construction,remodel or addition) Contact Person/Cont t Number/Email <br /> �'�'►Y u.�'�e.�+��t��.�'G�5�9. <br /> Number of devices(If low voltage) , <br /> De cr tion of Work to Be Done: l IUST/jZ�f l<��� �'U r I ���� �I�'T3, <br /> ��Ci(�c 7— �J�J �� �—r� <br /> � 1��i��"� L--(�r�� � I C.�( <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that!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 ^ ����� � � n <br /> performance of construction. That!am authorized by the owner of this property to perform the t `1 <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC <br /> A -��.��/� <br /> ignature Date <br /> REVISED 08/06/2014 <br />