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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.everetfwa.org <br /> I 001. e to q -G42 0k <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> pq lg. 1400 <br /> Square Footage(If residential new construction,remodel or addition) Canted Person/Contact Number/Email <br /> Number of devices(if low voltage) <br /> Description of Work to Be Done: " `C..t„+C t.-lei `% t \ r r cw t <br /> CLIA. S <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX:CODE':IS 3105 <br /> /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�o V <br /> violate or cancel the provisions of any other slate or local law regulating construction or the I D <br /> performance of construction, That 1 am authorized by the owner of this property to perform the; G ii <br /> work for which application is made and I comply with the State Contractors Law?8:27 ROW and <br /> 9 :20O WAC, <br /> Signature' Date <br /> aaviseornvos2ar-r <br />