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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.org <br /> / 47 (iLk-1 <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> 7 2i2y 5 fr14-af/')6 <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 1. 'N)�LA 63�c3-f b33`+30 <br /> State License Number (required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work a(VC p-r'/ / <br /> K 5rLp 3-34+7 56K) <br /> Square ootage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Z' 37-1 -trig3g9 <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: G(>C ��5 ,mac//jLi C-L /pa t,e_z_s G 746- <br /> /1 --(o/ES <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 $ /125–; <br /> C16)- <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# <br /> violate or cancel the provisions of any other state or local law regulating construction or the I S <br /> performance of construction. That I am authorized by the owner of this property to perform the G-D <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WACi <br /> 6-72-/5 <br /> Signatur- Date <br /> REVISED 08/06/2014 <br /> E /563 - S <br />