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� <br />�L�CTRICAL PERMtT APPL�CATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STR�ET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 �- www.everettwa.org <br />APPLICATIONS ARE ACCEP'TED FROM 8 AM TO 4 PM <br />I S 0� �,`J �-� �mo r e �� �� ����- <br />PROJECT ADDRESB <br />��, a <br />Owner <br />Malf Address <br />CiiY <br />5tatelzip <br />Phone <br />Tenant Mail Address City State/Zip Pho <br />�-o`�v'�� �C.�l�e - - � - - � 3bo� <br />Electrlcel Contractor <br />�+s� �- C� . i�jo x t�I <br />MaiE Address <br />� Rv���°��t c � <br />Stete License Numbar '"'� <br />t�z S i �� � �Q <br />Propoaed Use of Building <br />City <br />Square Footage (If residential new conslructlon, remodef or eddttion) <br />Description of Work to Be Done: ��� V'n O��� O� �, <br />„ <br />( Y� <br />D 6S3yJ'y3S <br />State/Zlp <br />���� �� <br />Cont�aci Price of Work <br />Contact person (Plan Raviaw) <br />��-�0 D {�1 G <br />Phone <br />NOT�: WIRIf�G IN NON-DWELLiNGS IS R�QUIRED TO FEE <br />BE 1N RACEWAYS, MC OR AC CASLE . �� d� <br />� <br />C�N Q� ��K�TT LOGAL SALES TAX CODE IS 3105 <br />l Rere6y aertify 1,i�at 1 have �ead and exemined this applicetion and know the same to be frue and <br />correcf: All prov/slons of Isws and ordinances govemrn tiris type of work wll! be complefed �(��� —' � O <br />whether.speci�ied herein or not. The granting of e perm�f does not presume to glve sufHority to � 1 <br />violate orcancal�fhe provlslons of$nyotherstafe orloea!!a►vregulatingconsfructlon orthe <br />performance af construction. Thsf / em sufhorl2ed by the awner of tltis properfy fp perform the <br />work for whlch appilcatlo» Is made and / comp�y vrith tha 5tate Contractors Law 18.27 RCW and <br />296.200 WAC. <br />