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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 — wvrw.everettvva.org <br />CIZU —I �n� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />141G Z- 5 I) lml; <br />/(Ja a �( k- '510 <br />PROJECT ADDRESS r }— %�tJ � <br />C kari4t c, Fl u-FF April IR100 tin KuViyli i '-tAlk._C;( <br />Owner Mail Address City Statelzip <br />Tenant 3 (a0 leirri`114 `�SD City Stale2ip <br />Electrical Contractor Man Atld ass cityStetelLip <br />To LtC.E-FC t q9 y 8 (/- <br />State License Number <br />Proposed Use of Building Square Footage (If residenthil new construcion, remodel or addition) <br />Descriplion of Work to Be Done: <br />r) I . _ <br />NOTE: SE IN REQUIRED TO <br />RACEWAYS, MC OR AC CABLE. <br />Contract Price of work <br />Contact Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 ` <br />Phone <br />Phone <br />Phone <br />FEE <br />�SO.oD <br />I 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 governing this type of work will be. completed <br />whether specified herein or not. The granting of a permit does not presumo to give authority fo <br />violate or can the provisions of any other state or local law regulating construction or the • <br />performance of construction. That 1 am authorized_ by the owner of this party 7o perform the <br />96 tr <br />plication is made and I comply with the State Contrac ors Law 18.27 RCW and <br />Signature ate <br />