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_ i <br /> I ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � <br /> ��I CEDAR STREET, EVERETT, WA 9B��� a �� � <br /> 3200 evereitwa.org � pa— `� <br /> 425-257-881� - FAX 425-257-8857 —�`f'/ G 3 <br /> � ppPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br /> � <br /> I <br /> ' L <br /> � � � v �� � i: v -��- �� <br /> PROJECT AODRESS � <br /> � � � V <br /> � ���� Phone <br /> � �i � State2ip <br /> T City <br /> Mail Address <br /> Owner <br /> _� <br /> I phone <br /> City StatelZip� <br /> Mail Address � �/� �� ��� <br /> Tenanl �7 - .r � - / �� � <br /> �C �- % ��/� � I £� ,/` � ' � <br /> �� Phone <br /> � �7 ✓��/ r''� � `�� City State2ip <br /> Mail Address <br /> i Electrical Contractor I <br /> �� � ` < �L ��G)O - tj Coniract Price of Work <br /> State License Number <br /> �� _ ', , a Contact Person (Plan Review) <br /> _�— <br /> Proposed Use of Building <br /> -- remodel or addition) �._ � � <br /> �I Square Footage(If residential new construction, � f�/ / �( i� ` ' /�' � /1 / <br /> � � �� <br /> , �� � r � T- � <br /> �I Description of Work to Be Done�. <br /> I FEE <br /> i <br /> I <br /> � � NOTE. BE IN RAC WAY3 MC OR ACI CABLEUIRED T �� o/� <br /> l� <br /> i <br /> I <br /> / 1 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105afion and know tbe same to b�e ed an� � '� �� I `� <br /> I hereby certity that I have read and ezaminedof'a permrt does not presume to gi�e authonty to <br /> II conect. All provisions o/laws and ordma�ng goveming this type of work wiPl be,comp Ci � � <br /> whether spealied herein or,noG 7he g p erform the <br /> violate or cancel the provisions of any other state or local law re9ulating construction or fhe <br /> 6cahon is made and I comply wRh the State Contrac(ors Law 1827 RC W and <br /> �il peAo�mance of construchon. Thaf I am authonzed by the owner of this roperty o P <br /> ,vo�k for which app <br /> 296200 WAC. <br /> � � �� � � - 2 �% � � �3 _� <br /> (�:.! �/�( ���� �„ <br /> - <br /> I Si9i aWre <br /> �L_—___—__—.__ � — ---_ <br />