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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.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ILloz 5E- Ern�asrT- 611411 L,lr14 Ll1 L-3,10 <br />PROJECT ADDRESS <br />11-0-2_1 2 <br />C12./1 -0`/Z- <br />S�ck,�tMsi l�1rt, Pd-opr<2TIr5 I$Ine UoN ICArG�,r>�J �Sbb iw /uF (',A Nzrutz Phone <br />Owner Mail Address City StatelZip <br />Tenant Mail Address City <br />Electrical Contractor Mail Address City <br />l�F /L ur IN 1 1('27) <br />State License Number <br />('Pill 111UCi II <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Description of Work to Be Done: <br />NOTE: B INNRAI EWAYS MEC OR AC CAB LLINGS IS REQUIRED TO <br />Slate/Zip Phone <br />Phone <br />—4/--0,yo <br />Cohtract Price of Work <br />0`11 u+ly-t_ A1 w') <br />Contact Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances goveming this type of work will be completed <br />whether specified herein or not. The granting of a pemut does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this roperty to perform the <br />work for which application is made and I comply with tile State Contractors Law 18.27 RCW and <br />296,200 WAC. <br />FEE \� U�� <br />F, lzl 1- 0 LF1- <br />