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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDArt STREET, EVERETT, WA 98201 9 �3 '-1 d <br /> 425-257-8810 - FAX425-257-8857-www.everetiwa.org ���vy'"aZZ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � <br /> v-� ; � L�.;l���-� ,-��`-� <br /> PROJECT ADDRESS <br /> Owner Mail Address Cily Stata2ip Phone <br /> �'_i���4-k.� (-�'r� .��� Ir � . l����� k <br /> Tenant Mail ddress Ci1y SUte/Zip Phone <br /> t�-1 ,1;;,1C�C� �- tic' � E �j<'��V�(k_. ,''�i(.% 1 L�iZ:tf�j- �v�' �"Vt,ttf. L��h1 ItfZv� <br /> Eleclrical C ntractor Mail Addruss Cily State/Zip � Phone <br /> 'Z;'� AtiISl /y� LID L�,��cr� ►/./e �� /11��,� <br /> Stalo Licenso Number Cor��P��of Work <br /> 7� �U��� <br /> � -� <br /> ( {�;��,�, I"�C':,,1 t�_<_c_-�c ,.t-4-- <br /> Propo`sed Uso of Bullding Conlact Person (Plan Review) <br /> Doscdption of Work Io 6o Dono: L—Y>�c'r r�4�: �i ;. � c' �� � � •��✓" <br /> NOTE: WIRRJG IN NON-DWELLINGS IS REQUIRED TO FEE <br /> OE IN FACEWAYS, MC OR AC CABLE. `�� G p <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerfily fhat 1 huve read nnd examined fhis application and kno�v the sarne to be true nnd <br /> r.oni:ct A/l pmvisions ollaws and orAinances got�eming lhis typo o/worh will bo comp/efed � �(;(1 L� -�t�7 � <br /> nfiefherspeci�ed herein ornoL The p�anling o/a pemut does not resumo to give aulhonty lo � <br /> violate or cancel tho provisions of any olher stale or local la�v reguPtiny consWction or the <br /> perfomiance ol constiucfion. lhat 1 am autherized by tlie o�vner o/fhis prope�ty fo perlomi fhe <br /> �vo�k lor which application is nrado and 1 comply�vifh thc Sfafo Confracrors La�v 18.27 RCl1�and <br /> 29G.200 WAC. <br /> � � l /, <br /> Si nature � <br /> � <br /> � <br />