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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.gov <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Y-oc'(ice, V�Avy VY Av V-eto �� q�)l dH <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> P�---�2-�Us-ak I bad NQ2�m 3 <br /> State License Number(required) City of Everett Business License Number(required) <br /> 42, Li 0,1 .H Z <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email tol/1� <br /> Z <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: �V1C�`� �� �V�� d� C-ti- � ►� (�,QLWyv�> <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 0 11 <br /> I hereby certify that l 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 ^ ��J <br /> performance of construction. That/am authorized by the owner of this property to perform the t <br /> work for which application is made and l comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> — &r-- --� <br /> ature Date <br /> REVISED 08/062014 <br />