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. <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �r -�y -o � <br /> 425-257-8810 - FAX 425-257-8857 —wv�w.evereltwa.org L � �7�� `�� Z <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �7��' 1 f�'��i�� � �� <br /> PROJECT ADDRESS <br /> Owner 1.1ai1 Address City Stale/Zip Phone <br /> Te��anl Mail Hddress City State/Zip Phone <br /> �`���rn„ fi�(�+��'� �-C�. ��222��b�� ��' 1�.���n�,v�� u,S�9K�1 hZS-1�K3 (�S <br /> Eleclric3l Conlraclor Mail Address Cily Stale/Zip Phone <br /> c` <br /> �`'i �7-0 7�= 5��K> � ��� <br /> Sta�e 'icerise umber Contracl Price ot Work <br /> �-1.��07G zyCt= — — <br /> Proposed Uso ol Buildin� Cont,icl Persun (Plan Fevimv) <br /> Oescripliono(WorkloOcDun��: _1/d`���L`�—�.�-=-�i%�"�il1�.�.� � ,Zil1LE -- ---- <br /> � <br /> � 7 �t }c�� � �On �� 7�� � <br /> NOTL. WIRIf�G IIJ NON-0W[LLWGS IS R[QUIRED TO FE[ <br /> BE IN RACEVVAI'S, A4C OR AC CA�LE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhat 1 ha�r read and ezantined this applicaticn and kno�v the same fo be f�ue and <br /> corrocL All provisions o/la�rs and ordinancos govemm,q fhis type o/�ti�ork will be completed <br /> whefher specdied herein or nol. Thc�ranfing ol�pernut does nof presimte fo give aufhori�y to <br /> violate or cancel flie provisions oI any other state or local lnw re�ulafing consfruction or the <br /> peAonnance ol construcfion. That 1 am authoiized by fhe owner ol lhis propeity fo perfenn fhe <br /> work for which applicalion is rtiade and 1 comply reith fhe Sfafe Centrncfors Larv 7827 RCLNnnd <br /> 296.200 WAC. <br /> � [ L <br /> _ ��,ti-f'1,�� '��I�CPiI ���2�f-�lJ� ��� " ��'vZ <br /> Signature Oa e � <br /> � � <br />