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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.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />-�30.�7 /�l� t�r�,G,tci_ A�c <br />PROJECT ADDRESS <br />GG�'�c.ic�° 1�2u���=�Pi7�s �4J``I 11-�c���ub.a« Av�°���u �v[�c.:7 �,/�I 9Y1�1 3/�c�-.?Bo pGG1 <br />Owner MailAddress Cily Slate2ip Phoi�e <br />�J�S /'iaiNT13A�L '»J3 /�l���cu��+c� /iv,[ i_`v.:[�Ir ti/f 9Y1o1 ti�i-.257•9b��U <br />1 enanl Mail Address Cily Slatc2ip Phonc <br />�I.FClIQI� <br />6leclrical Conlraclor <br />l�AIfL/E i q1 L QU <br />Stale License Number <br />,.7Y0`( <br />Mail Address <br />Trn')�': �' �Rin�Trt�9�L <br />Proposad Uso uf 13uilding <br />Description o( Work to �e Done: i� � � FOV� <br />NOT[: WIRIIJG IN NON-DW[LLINGS IS R[QUIRED TO <br />I3[ IN RAC[1NAl'S. R4C OR AC CADLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />/ <br />6{✓� i..v�2tirr :,/�1 �1Y.: <br />Cily Slate�Zip <br />� $,7UUyv <br />Contract Price of Work <br />Conlact Pcrson (Plan Revicw) <br />aiLL <br />1 hereby catily fh.if 1 ha��e read nnd examined fhis npplicafiun nnd knon� the same fo be fnie and <br />conect. All przrvisions o/ laws and erdinances c�overnmg this 1}�pe o( �ti�ork will be complefed <br />whether specdied herein or noL The granfing ol a pennrt does nol presume to gire airthority to <br />viola(e or cancel fhe `�mvisions ol any ofher sfale or local Imr regulafing conslruchon or the <br />perlonnance of consl�ucfion. Thaf I am authorized b}' fhe o�vner o! this proper7y to perlonn the <br />work (or which application is mado miA 1 cornply mifh fhc Sfafc Contraclors La�v I827 RCW and <br />29ti.200 IhAC. <br />Phone <br />FEE <br />�a�.;d <br />� <br />%`_ �_ ,��_ �i-�-ic ;o0�-�03 <br />s���,:,���«: o�<< <br />