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ELECTRICAL PERMIT APPLICATION <br />CITY OIF EVERETT PERMiT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8610 - FAX425-257-8857—www.everettwa.org L ��'L� `.�(,( <br />/' <br />APPLIC<1TIONS ARE ACCEPTED FROM 6 AM TO 4 PM �_� f L' � <br />� ; � i�' i � ( � . � 6 ; y <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />r��� � �_ <br />Mall Addross <br />Mail Address <br />���,.`riP�l��('_r��f'rr (�c?n��� ���Y%t�%`'S� 1. <br />Eloclrical ConUador Mall Address <br />,��„t e� 113�3 ri�,�7�; �� <br />b <br />�J �'Z <br />State License Numbor <br />G���s�e / �ue�•�G_S�s�,,o <br />Proposed Us of ilding ' <br />Oescription o( Work lo Do Done: <br />i_4 u' <br />a <br />City <br />6 <br />Slale2ip <br />Slate?Jp <br />S�ate2ip <br />Coniracl Price of Work <br />Contad Pereon (Plan Raview) <br />� <br />NOTE W IRIIJG IN NON•DWELLIIJGS IS RE�UIRE=D TO FEE <br />8E IIJ RACEWAYS, MC OR AC CADL[. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />! he�eby certi!}� fhaf I bavo read and examinod fhis application end know fhe same fo be truc anA <br />rorrocL All provisions ollaws and ordinances go��eming fhls fype ol work will be comp/efed <br />wltefher spec�lied hemin or noL The g�anfing o/ a permif Aoes nof presumo to give aufhonq� to <br />violafe or cancel the provisions o/ any other state or local /a�ti- regu/nfing cons(ruction or fho <br />perlomiance o/ cons�ruclion. Thof 1 am aufhonzed by fhe owner ol this property tu perform the <br />work lor which application is mado and 1 comply wifh (he Sfafe Cenfractors Law 1817 RCW and <br />2,98.200 WAC. <br />Phone <br />Phone <br />Phone <br />