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r <br />ELECTRICAL PERMIT APPLICATION I <br />CITY OF EVER�TT PERMIT SERVICES �� �o � i <br />3200 CEDAR STREET, EVERETT, WA 98201 �- <br />425-257-8810 - FAX 425-257-8857 - www.evereltwa.org � 0 c�D Z� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��r.--�< � D<,�, �;>��� :%, Gr,� �7f� G.%/' <br />� <br />PROJECT ADDRESS <br />,,/ , <br />L/CUJ fJd �P (it�;l <br />Owner <br />� <br />J`��'?T-' <br />Tenant <br />=� L G L' L' /' <br />Eleclrical CoNractor <br />hlail Address <br />Mail Address <br />-r,' � 136.2/- <br />Mail Address <br />�f_''QI:L� ��%7�L <br />Stale License Number <br />C �v'YC� <br />Proposed Usc of Building <br />Descriplion of Work to Bc Donc: <br />.� c- ve r <br />Ciry <br />Cily <br />9 �a: <br />Slale/Zip <br />StatelZip <br />Phone <br />Phone <br />l/,%% Sj7t•��i`JO/J� �✓/'i� ! �� �z <br />City SlatelZip yas��.�-Y/��a� <br />•7 � � <br />Contract Price of Work <br />Contact Person (Plan Revie�v) <br />L,`G �TS qkd� <br />NOTE: W IRING IN NON-DW [LLINGS IS REQUIRED TO FEE <br />BE IN RACEWAI'S, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 he�eby cerii(}� Ihat 1 have read and examined this application and know the same to be tnie and <br />correcf. All provisions of laws and ordinances governmg this t}�pe ol �rork will be cornpleted <br />whefher speci6ed herein or not. The granting of a perrnd does nof resume fo give aufhonty to <br />violate or cancel the provisions ol any ofher stafe or local law reguPtin� consVuc6on or the <br />performance oI cons6ucfion. That 1 am aulhorized by fhe o�vner o/ this property fo periorm the <br />wo�k /or which application is made and 1 comply �vith Ihe Stafe Conf�acfors Law 78.27 RCW and <br />296.200 WAC. <br />�o�oa-o��i <br />