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• • <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 — www.everettwa.org <br />� <br />C�� ��� -� � C�_ f-1 � t <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />� ^ <br />� <br />�?`-; /t?��, ���c tCc� <br />Mail Address City <br />Mail Address City <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />��n r Ic�-�; L �c� �,�,� f����G:�� ��c�C�+�-l� t,�; ���,��� z��_ ��;..5���� <br />Electrical Contractor Mail Address City State/Zip Phone <br />l��C.�.�G-�-,� �Z:�t�; <br />State License Number (required) <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />C.�C� �L" � `� � <br />City of Ever tt Business License Number (required) <br />��Ut^� � ��f'� <br />Contract Price of Work <br />��-F�� Jc�.u��tw� �c� 2�_�`� ' �'t ,��`� <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: ..s��-�'�-�` 0. C C�`�� '�1 �✓�'t('_ C� �Q �_� a I✓�S-�-L j' <br />� ✓1S _ r ✓1 <br />� ��1 I <br />/s� l " ' <br />. <br />�'�11�,1,j_T-�C✓!LY � ' c �-�� v�rl C�i ��.t-� � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances goveming 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 <br />violate or cancel the provisions of any other state or loca/ law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with fhe State Contractors Law 18.27 RCW and <br />296.200 WAG n n „ <br />re <br />REVI SED 08/06/2014 <br />1 � /'�-/� <br />FEE <br />( � � -� �� <br />PERMIT# <br />E �� rZ - v�l� <br />