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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 2 —�a_13 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> ��3�a--��3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � <br /> �s3c� �� ,/6� ,�� <br /> PROJECT ADDRESS <br /> �.%,� C7Tc�/��.� ' C:'1�I� .�S.�V �(`l l� �-y' �!7i�1!i r� GV� GO Z[�� Phone <br /> wner <br /> I�Aaii Address City State2ip <br /> Cit Stete2ip Phone <br /> Tenant MailAddress Y <br /> Y� , Z ZZ /'�-c Gr�; f-r (-c��� c�l `!'�ts'z Yu` t3�o -s�i�'r <br /> ' State2ip P1ona <br /> EI clrical Contractor Mail AdCress �'�Y <br /> ���0 �v U <br /> C u'�� ' � �� '— CoMracl Price oi Work <br /> Stal License Number <br /> Cantact Person (Plan Review) <br /> Proposed Use ot Building <br /> I <br /> Square Foolago(If residentiel new construclion,remodel or additicn) <br /> Descripiion vf Work to Be Done: <br /> ... '��/� � f��3C�ci.a "7(�!$ �`!J� �/r// !✓O'/'T"/� �`/.-i�f <br /> t <br /> ' FEE <br /> �JOTE: BE�IN RA EWAYS MC OR ACICAB EUIRED TO ��� <br /> �`. <br /> CITY OF F.VERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerfily Ihat 1 liavo read and examined fhis applicafion and know fhe samo to be W e and f !2 0?� � 6 � <br />� corrnct. All p!ovisions ollaws and ordmances govemmg this typo ol�ti•ork wtll be completed r ,� <br /> u�hefher:pecified hr�ein ornot Tho granhng ol a permd does nol P�esume to give authonty to "' <br /> violafe o�cancel tho provisicns o/any olherstafe orlocalla�v mgu�aliny consfn�ction or/ho <br /> pedomiance o/consPrucfion. That 1 am aufhonzed 6y the mvner of this prope�ly(o pedonn the <br /> worH Ior wlnch appl'cat(on is made and 1 comply�vith the Slafe Contrac(ors Law 18.27 RCW and <br /> 296.200 WAC.� J <br /> ,: �� �/'z/�L:��Lz,`-�" 7�/� � � <br /> _�� o�ie <br /> . Signature <br />