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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.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />,�`7� �L/ /�ev��-1�9 Lan� <br />PROJECT ADDRESS � <br />� o �� �oB <br />�o ��o -035 <br />�� �� __['1 Jtrl'S.i —_�/ / `� _Yf���/V�� IV�'W <br />O�vner A1aiI A�ldiess Gty StatclZry� Phone <br />TCI1B0� <br />Eleclrical Contraclor <br />htail Hddress <br />Idail AdAress <br />_��`5 C�" I � � � l .l <br />S� le License Number <br />'�C' :J) C��F;JC ti,� — <br />Propose� d Use o( �uildin9 <br />Descriplion of Work to De Done: <br />NOT[ WIRING IN NON-0WELUNGS IS REQUIP,[D TO <br />f3[ IN RACL=WF�'�'S, �iC OR AC CA6LE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />G�y, <br />Cily, <br />Statc/Zip <br />Stale�Zip <br />CoNract Price o( Work <br />Conlacl Person (Plan Review) <br />I hcreb�� �.ertdy fh,+f I h,ivu rr„d and cAUmirn�d Ihis opplication .md Ano�v fhc sarne to be fnie and <br />couor( All p��usions �,l l���ti�s and orJinances �a�rrnin�� Ihis f}�pe ol �rak �rill be complefed <br />whrfhe� spocdicd hc�c�n or nof. 1 hr. 9r,anting ol a pe�rnd does nof piesurne fo c�ive aufho�ity fo <br />violafo nr c.rncel fhe prorisions o! any other stafe or local law rec�cil��ting construc[ion or the <br />pe-r(ormance oI consfiurtion. Thaf 1 am aufho�ized by fhe owr.ei o! this properiy fo perlann fhe <br />work lor which applir.a6on is made and 1 cornpty �vAh the Stafe Cortfracfors La�v 1 H27 RCW and <br />796.200 lNl�C. <br />�— �\ <br />-��'--`�-- -� - =1�$--- <br />s�;;��.�i.���� o.�i� <br />FEE <br />I <br />�i,`�,AL�-( :zi�j <br />Phonc <br />37-J,3�� <br />Phone <br />