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ELECTRICAL 'PERMIT APPLICATI�N <br />CITY OF EVERE:TT PERM17 SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM S AM TO �3 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />(=�L� il� �-l�Ci <br />� ✓� <br />`, t� (� r<C�-i�n� Cv- A <br />PROJECT ADDRtSS <br />7< � I <br />��%;iJi��: /� .�'!Ii7f ) / ,J'•LG ��Tr-��.airf—�)r� �e-�G�/J% J�'Zo5 �1<'S -��/� <br />Owne� Mail Address City Sta:e/Zip Phonef�� (.;� <br />✓ <br />fensnt <br />Mail Adaress <br />�-.. ,• � <br />"���% �aAP^:�- `-�G`�r�� % �l F-v+'cLT� �- <br />Electrical Contraclor Mail Address <br />.�f�Ati�55 ryZ�/� <br />State License Number <br />,%��� �. ;,�,,, ,�._;.. <br />Propesed Use of Buiiding <br />Description of `Nork to Be Done� <br />� <br />City State2ip Phone <br /><jzs'-z5'��2/ � <br />l / �v����c � �%�Cl/�9�Za / -- <br />NOTE: VJIRING IN NON-D\VELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SFLES TAX COOE IS 3105 <br />City <br />L- % rC r L <br />State;Zip <br />�,n _ <br />�G�n�� .� <br />Contract Frice of Work <br />Contact Person (Plan Review) <br />I hereby certify fhar 1 have read and examined this applicafion and kncw !he same to 6e trua ano <br />correct. All provisions of laws and orAinances govermng fhis type ol work �ri116e cempleted <br />whether specilied here�n or noL The granting o( a permtl does nct presun, e to give authoriiy to <br />violate or cancel the provisions o(any other state or locallaw regulating constructwn or the <br />performance o/ consi�uchon. That I am authonzed by the owner of this propeRy to perform the <br />�,vork (or which applicatrcn is made and I cemply �vith the S�a(e Cuntractors Law i 8.27 nCW and <br />296.200 INAC. <br />i"l 1�,,�/�/ S�� ��L�� _ <br />FEE <br />Phone <br />`���I, O <br />� <br />