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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 /> 41 45-(04 <br /> 2700 c -s <br /> PROJECT ADDRESS <br /> D-ef jOO 3 vv.- s1 r'r z, P601 - <br /> Owner Mail Address City State/Zip Phone <br /> ane c <br /> 115- 1,iiO ?' oz, tiv • c ets �'� evet* �i 4 <br /> Tenant Mail Address City State/Zip Phone <br /> 12Z I 2/ Ave_ iv. 4 - T4,6 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> -b 06) <br /> State License Number Contract Price of Work <br /> tI t U—S <br /> Proposed Use of Building Contact Person (Plan Review) <br /> k <br /> Square Footage(If residential new construction, remodel or addition) <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: ►' C441/4/114)cli-alt—T <br /> J <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I 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 <br /> performance of construction. That I am authorized by the owner of this property to perform the E <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WA <br /> l <br /> S.a re Date <br /> REVISED 3/20/13 <br />