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ELECTRICAL PERM�`I APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — �wdw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� � 1 L� <br />��O L �%G✓ f�l L�Vol�ci 1n DO <br />PROJECT ADDRESS <br />L� � C T� �I�`-�vvr � l � +� <br />OWner Mail Address Cily Slate/Zip Phone <br />%� Sy ���� <br />l_v�„�, l—��q�,tl;��C.r'� C C�Z`� �GG-F-�I S-F v�/lti% J 1-��0i��.JuGo� �1�= � <br />Tenant <br />EleclriceJ Centractor <br />Slato License Number <br />Pruposed Use of �uildinc� <br />Description o( Work to �e Lone: <br />tdail Address <br />�1ail Address <br />NOTE: �VIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN R,4CEWAYS, MC OR AC CABLE. <br />City <br />Ciry <br />Stale2lp <br />Slale2ip <br />Conlract Price oi WorY, <br />CoNacl Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily that 1 have read anAer.arnined this application and know fho same to be true and <br />r,onect. All provisions ollaws and oiziinanr,es goveming this fype olwcrk will be complefed <br />�shefher spea(ied herein or noL The granfing ol a perm�f Aoes not resume fo give aufhonty fo <br />violafe or cancel the provisions ol any olher sfafe or local la�v reguPrn,s �o�,SrN�oo�, o. u,� <br />per7onnance o/ consfruction. That I am authonzed by the oivner ol this property fo pedomi the <br />�vork lor �vhich ao�lication is made and ! comnlv with the Slafe Conlraclors Law 18.27 RCW and <br />� G� <br />FEE <br />j �� i � `�� <br />Phone <br />Phone <br />