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� <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•everattwa.org � �i q �a <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM [—�l DO7—07 <br /> ���: � 5 u� �• s -�„ ��1 <br /> PROJECT ADDRESS <br /> ''� I / � �i ' S( 3 K //i ��.,c•� L✓.�' I`�`''� l_nG ?9�'—USd � <br /> �Si i � L Y 1� � � �� � �� /ti C 7< <- Phone <br /> Owno� Mall Address <br /> Clty Slale2ip <br /> Tenanf Mall Addruss <br /> Cily SlalelZip Phone <br /> A Ai 5 �cnvc�u/ r✓,� 9`-?�L .c� 97v rG 7 <br /> /fL� U��-y5 � � Cc f � Z7C�[ T� � v! <br /> Eleclrical Conlraclor Mail Address <br /> Clly S�alerZlp Phone <br /> I S i t '�� <br /> � �� � � 1 C ��7'�� ; — Co Iract Prlce o(Work <br /> Slate Llconso Number <br /> �/c � C� /�"� �1 <br /> /� ; !• i,t ��. c" � � <br /> Con act Porson (Plan Rovlew) <br /> Proposed Uso 01 Bullding <br /> Description o(Work tn Do Dono: � S / � — <br /> NOT[: OE�RN�AC WAYS MEC OR AC CAB�UIRED TO <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> co�m�tty All pro�isi ms ol la vs a�d o�finmicos fl voiiuii�Ihls fyPo o/Hork�will bo con plefe� �n� <br /> v'olnfe�or cnnccl tho`r�ov s�ions of any olhe�r�stafo or locatl�n v regulnting�cons rucfioi orr�fl o f o <br /> perlormance o!conslruclion. Thnf 1 nrn nufhorizeA,by O�e owner o/fhis property fo peAomi fhe 1 O� � _ 0 �� <br /> 2 8k200�WAC.nn��I�c�t�����s maAo nnA I compty wifh tho Sfafo Confrocfors Lew 1827 RCW end <br /> � <br /> J � - -�- i�r l�% <br /> �'sL� /�� " �=oa�e � <br /> --�-'Si<lnalure .. _. - <br />