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C <br />i <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wvuw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FftOM 8 AM TO 4 PM <br />�5 �J�7 a-N c� �-I <br />PROJECT w�DRESS <br />l�'�-Ot-�-Sa..� S <br />C��t.t�l�- <br />Owner <br />LW! 1 <br />Tenant <br />Po 6 36/v <br />Mail Address <br />Mail Address <br />City <br />City <br />State2ip <br />Staterzip <br />(, -0 5-1 '� <br />��zob-oa5 <br />��� <br />33fs a <br />Phona <br />Phone <br />��1� A.1 �'-1Z <br />ElectricalContractor MailAddress City State2fp Phone <br />State License Num6er <br />�' `9� � <br />Proposed Use of Bui ing <br />Square Footage (If residenlial new construction, remodel or addition) <br />���� <br />Con ract Price of Work <br />Contact Person (Plan Review) <br />DescriptionofWorktoBeDone: � �uv���%�� 2�������`"' eJ���"�� 1�Prt� <br />I� ( G IA-TI�� <br />NOTE: ERN RAC WAYS, MC OR ACI CAB EUIRED TO <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3�05 <br />I here6y certify fhaf I have read and exemined fhis application and know the same fo be tn�e and <br />correct. All provisions of laws and ordinances goveming this type of work wi116e completed <br />whether specified herein ornot. Tha granting �f a permit does not presume to give authonty to <br />violate orcancel the rovisions of any ofher state orlocal law iegulating constn�ction or the <br />per(ormance of cons�ruction. That 1 am authorized by fhe owner ol thisproperty lo pe�io,�n the <br />�ss 200 WAC application is made and I comply with fhe State Contrac(ors Lavi 18.27 RCW and <br />FEE O <br />� �5� <br />�'��aaYo-'025 <br />