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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 />qPPLICATIONS ARE ACCEPTED FROM 8 AM'f0 4 PM <br />� Z S-- E,� �� I,J�� S�,�rr 3�55 <br />PROJECT ADDRESS <br />�� _07 �/7-. <br />C—«�i—oy3 <br />ST.horVl-Si ��^'lrtt P�n�2���5 I�SI�o VuN IC+12�7��i�J �SOD yp�,�iUF (��}- ��2�IStale2i Phone <br />Owner � Mail Address Cdy P <br />Tenant <br />Electrical Contractor <br />Mail Address <br />Mail Address <br />I��IF�2�� rn i �(n 7 �"� <br />Stale License Number <br />�ll�N�111���C��41 _ <br />Proposed Use of Building <br />Square Footac�e (If residenliai new consiruction, remodel or addition) <br />Description of Wark to Be Done: <br />NOTE: EIRN �AIC WAYS MCC OR ACICAB 4UIRED TO <br />Ciry <br />City <br />State/Zip <br />ZZS�o� <br />Contract Price of Work <br />i�� i u��a � t, ✓�-nsu�� <br />Contacl Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cedify (hat 1 have read and examined Ihis application and !<no�v the same to Ge true and <br />correcl. All pruvisions of laws and ordinances govermng this fype of wod< will be. completed <br />�vhether spea(ed herein or not. The granting of a pemut does notp resmne to g�ve aulhon(y to <br />violate or cancel the provisions of any olher state orlocal law regulating construction or the <br />pedormance o( co�tstruction. TYat I arn �wthonzed Gy the ownerof fhis �rope�ty lo pedorm the <br />ivodc ior which application is made and 1 comply'wilh the Stale Confrac(ors Law 18.27 RCW and <br />2se.zoo wqc. � , <br />FEE <br />�O � <br />Phone <br />Phone <br />� �z�(- ��f3 <br />