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�LECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERE'if, WA 98201 �� � a�—! �, <br />425-257-8810 - FAX 425-257-8857 – www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />1 S%C� 5�%r� �� � �/ �vi r.� 3�'S, <br />PROJECT ADDRESS <br />S-r-E� � <br />Owner <br />1 <br />Tenant <br />Mail Address <br />Mail Address <br />EledricalConlraclor MailAddress <br />� l/� l� �-�S�C� �� C � <br />State License Numher <br />I `� rn � 1 <br />Proposed Use of Bwlding <br />Square Footage (If residential new construclion, remodel or addition) <br />Descnption of Work to Be Done: U l� v'/ 92 �-I � T <br />1 / / <br />� l ii �,� S l � !� 1/ P <br />City <br />Ciry <br />City <br />Clall�lg% <br />S�atelTp rnune <br />w� ��ao� <br />Stale/Zip Phone <br />State/Zip Phone <br />�i `l a �� <br />Contract Price of Work <br />Contact Person (Plan Review) <br />NOTE: BE�RN �C WAYS MC OR AC CAB EUIRED TO <br />CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br />I liereby certi/y fhat I have read and examined this application ane o% work will be com lefed and <br />correct. All provisions of laws and ordinances govemmg fhis typ P <br />whe(her specilied herein or not The granfmg of a permd does not resume to givP a�thonty to <br />violateorcancelthe provisionso(anyofherstateorlocallawreguPGngconstruchonorthe <br />perfomtance o( construction. Thaf I am authorized by the owner ol this property fo per(orm the <br />work for which applicahon is made and 1 compty with the Stafe Contracfors Law 18.27 RCW and <br />296.200 WAC. <br />1i-a�=�a <br />FEE <br />� �g���5 <br />� �������� <br />