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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> , ��� ���t`/� �-(�L <br /> PROJECT ADDRESS <br /> (�7 i — <br /> � `�"1/J <br /> �,�.� �. i� v,�.� � �Z z�Z (���,"� l��,� L�e.r��r� Gl�i� y� z S <br /> Owner Atail Address Clty SlatelZip Phone <br /> Tenant Afail Address City Stale2ip Phonc <br /> Eleciricnl Conlraclor Mail Address City State2ip Phone <br /> State License Number � Contracl Price ol Work ��Z � <br /> IJ�C//�, / <br /> ��S� � � � ���'�ll 3�'y-s.;S3 <br /> ���-- --fb�f`t>-f��,.�C�c`3f–�_ � � <br /> Proposed Use o(Buildin� Contac Person (Plan Revie�v) <br /> Descriplian af Wnrk�o Oe Done: � '��� — `" �����71✓�� � <br /> i NOTL: VJIRING IN NON-DW[LUNGS IS Rf:QUIRED TO FEE <br /> f3E IN RACEWAYS, IdC OR AC CAF3LE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 / � � �� <br /> 1 he�oby certi!}�fluit 1 ha��e read nnd examined fhis appfica6on and kno�r fhe sarne fo 6e true and �`� �� � � � u <br /> correct All provisions o/la�rs nnd ordinances govenwig fhis(ypo of wo�k will be cornplefed <br /> nhefher specified herein or not The grontinp o/a penmt does nof xeswne to give au0ionty to <br /> violate or cancel fhe piovisiens ol any olher sfato or locnl In�r mgulating consirudion or fhe <br /> perlormance o/consfrucfi0n. Thof 1 em nuthorized b} tho c�sner o!(his propert}�fo perfonn fhe <br /> trork(or�rhich applicntNrf is made and 1 comply�ri(h (he State Cen6ac(ors Lau� 18.27 RCtM1�and <br /> 296.2001NAC. �� <br /> � � � � � � �� ��`� <br /> � <br /> Sic�naturo � ���e <br />