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ELECTRICAL PERMIT APPLICATION <br /> ` CITY OF EVERETT PERMIT SERVICES . <br /> 3200`CEDAR STREET, `EVERETT, INA 98201 <br /> 425 257-8810 - FAX 425-257-8857-www.everettwa,org <br /> , ,.;� 6 � �� <br /> PROJECT ADDR S <br /> /"d l�(L �llll L 1?L�l/�I �/`�'' ZZ2� Jt �l/li�✓!A/'C �� �82� �Z�Z� ��� <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> . ��� ��rvG GL c. 323-a 3�Z���vc.t'.��.t�rAs��+� � 1��5�.� Zc6�31Z�3 <br /> 'Elecfrical ContraCtor ` Mail Address City' State/Z�p Phone <br /> :.- <br /> �/Q�C,E/�IS'4��-. ��G��T <br /> tate License.Number(required) City of Everett Business License Number(required) <br /> _ � <br /> �G ���GG � <br /> ' Proposed'Use of Building Contract Price of Work <br /> �,�0 �r���/��� <br /> Square Foofage(If residentiaf new construction, remodel or addition)' Cqntact PersonfContact Number/Email <br /> Number of devices(If low�oltage) <br /> Description of'Work to Be Done: G�CGt� `°`�/' �/S/ ��4 S 1ilCE' � �C�ri'/�� <br /> � i r�s� �7� ��� �a� $� T�-�� ��9� �.s� . f�,�.. <br /> FEE <br /> CITY'OF EVERETT LOCALSALES TAX CODE IS 3105 ' � <br /> � � <br /> I hereby certify that l nave read and examined this application and know the same to be true and <br /> correct. All provisions of laws antl ordinances goveming this type of work will be completed <br /> whe�her specified herein or not. The granting of a perrnit 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 pertorm the E ��'�� -1� ' <br /> work for which application is made and l comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � , /� �lZ �-���� <br /> nature Date <br /> REVISED 08/06/2014 <br />