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_ � -� -oW <br /> 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.everettwa.org <br /> A?PLICATIONS ARE ACCEPTED FROtd 8 AM TO 4 PM <br /> , (—� <br /> i ) . �,. � � '�l h� <br /> PROJECT ADDRESS <br /> 7 �� ' r <br /> ) � � , '-�•�- � ��r' : ' )� , 'I ��.�i �%. _ '.'V_ i� . 'yF_�� <br /> �`� � ( �/�:�, ' _ / ! ! / � ��'�-- � Sla�e/Zip Phone <br /> Owner Mall Address ����� <br /> Ten�nt Mall Address ���Y <br /> Slale/Zip PPono <br /> � �� , ', / _ <br /> � �� Sl,de/Zip Phona <br /> Electrical Conlrar,tor Mal Address �'�y' <br /> Slale Licanso Number Con�ract Price of Work <br /> � �, �� Conlacl Porson �Plan Reviow) <br /> Proposed Use of BuilJinn <br /> I � � <br /> • � i� -�-� r� .�� r _ >, .� J '� - <br /> Doscription al Work lo De Uune�. - ' , �, i � � �c c��_ <br /> � � � / <br /> ! <br /> NOTE: �E�RN RA EWAY�S MC OR AC CAB�UIRED TU <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heroby certity thal I have ret+d anA cxanunnd fhis epplicnhon nnd know Ihe seme fo be Wo end <br /> correct All prowsions o!Inws and orAinnnces goveming this type ol worh will be complefed <br /> whefhor specilieA herein or noL Thc��anting o(t+pornut Aoes noll�rosume fo give eufhonty fo <br /> viola(e or cencel fhe provisions o/ony ofhe�sfafe or locnl lsw reyu nfine�construcfion or the <br /> peAorniance n(conslrucfion. Thnf 1 flrn euthorizeA by Ihe owne�o/fhis property fo peAomi fhe <br /> work !or whir,h npplication is maAe enA 1 compty wifh fhe State Confracfors Law 18.27 RCW anA <br /> 29G2�10 WAC. <br /> _ / / , / / ' Ij <br /> l�.�'i i ��'I' -f i . �- [aZ_� `� — <br /> i_ <br /> �-�-�-µ�- Sipnalura � <br /> — '�l�C'a {i`1 � <br />