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ELECTRICAL PERMIT APPLICATION <br />GITY QF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Ii �',.� /� (.''�'� �; -: > !,�i- �:____ <br />� <br />I �Y�1-✓��jt1� t'✓I�ifY'� �L�- <br />PROJECT ADDRESS � <br />I Otvner <br />�� 3�02 BC <br />A7ail Address <br />L I S�� ��. �BoL <br />A1ail Address <br />' A1ail AAdress �D <br />� j����7r' rK- <br />S,ale Licon'e NumLer <br />I <br />�l( �P l� <br />! rro��osc� U.sc o1 6uildinp <br />I'cscriplion ol Wor4. �o [3� Donc: <br />Cily <br />City <br />Stale2ip <br />State/Zip <br />SIJIC/Zip <br />/.S�O "` <br />Conlract Price of Work <br />C���rson (Plan Review) <br />Phone <br />Phone <br />Phone <br />� NOTE: b'VIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />� BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVEReTT LOCAL SALES TAX COD� IS 3105 <br />! hereby cerfily thaf 1 have read and examined fhis applicalion and knon� the same to be true and <br />�. co�recf. All prowsiuns ol laws and ordinances govemuig tltis type o/ �vork tvill be completed <br />whefher specilied herein or noL The granting of a pernut dces nof resume to give authorrty to <br />violale or cancel the provisions o/ any other state or local la�v reguPting consfruchon or the <br />� perlonnance of construc6on. Thaf 1 am authonzed by Ihe owner ol this propeRy fo peAonn fhe <br />woik (or which applicafion is rnade and I comply with the State Contractors Law 18.27 RCLN and <br />29G200 WAC. 1 <br />�� 1% <br />,, - . � � i�, .-� �- � <br />, , , ,, � --r-� �' ," ,��)(�� <br />� � Slm�aiur�e • � Date � <br />� � � <br />