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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.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> ,� , , �� �';' .�;>:• , . /i4� <br /> PROJECT ADDRESS <br /> . <br /> 1- � <br /> Eti�-n.<�r �^,r<�i�ri il-"t; �i17 r^�;. ,.�:��.-�.:_�� ��;' rvr-��-;� r,��/1 — <br /> Owner Mail Address ciry SUIe/Zip Phone <br /> � <br /> ' A270 l-t:��,, j�;.7E. �j/1_<At�t,.nV/�vr �"✓t:�r=" l.,,i .� _ <br /> Tenant Mail Address City State/Zip Phone <br /> n <br /> ��IL•�,/S �'L✓; /J�avN• �u�%.:-� i S;- .�l�cih:iJ4d,t��v� j:'JC� �4J ' [v7I- 7/Cr <br /> El�cirical Contractor Mail Address Cily State/Zip Phone <br /> f/i/l/5,��%$ �1L-l•✓ ¢�5�%�', <br /> State License Number Conhact Price of Work <br /> ,�'cTiauC /19i�f ti��S'/,'iN�-' <br /> Proposed Uso of Building Conlact Person (Plan Review) <br /> Descriplionof�VorkloBeDone: ���LL ,��.E ���Si-ur:+�,vlYilc`7C'fi'AF�N=L �i'r'r�-j� ,S��.r� <br /> NOT[: WIRING IN NON-DWGLLINGS IS REQUIRED TO FEE <br /> BE IN RACE\NAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf I have read and exemined fhis application and know the same to be We and <br /> correcL All provisions ollaws and ordinancrs govetpmg fhis q�pe ol�vork will 6e cemplefed <br /> whefher spealied herein or noL The granfing ol a pemut does not �resume to give authority to <br /> violafe or cancel ihe provisions o/any other stafe orlocallaw regu�afing construction or the <br /> perfonnance o/consfruction. 7'haf!arn a honzed by the owner o/this propertylo perfon;i Ihe <br /> work lor which application is made and I�mgly with tho Stafa Contractors Law 18.27 RCIh�and <br /> 296.200 WAC. i , <br /> . , <br /> ��' �� _,/,. % <br /> Signature Date <br /> �` L �vl IZ � <br />