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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREl7, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.e��erettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> (} � . <br /> f �C:�� �1_ \C.C�\�V L.�(� ,`J'� � � <br /> L'� I <br /> PROJECT ADDRESS <br /> �o�`�� �d�� e..w L�v-������.��ur5 �_L._�. �u��� '�� u - �- Z,-� �- <br /> Owner Mail Address Cily State2ip Phonc <br /> Tenanl hlad Addruss City Slale/Zip Phonc <br /> ��-�'1\��,�1 �:,�.C.-CV\L. C(� !-�'\� _ �,��`'�1 �'�Z- �-� �`�1 � <br /> [IeGricat Contracloi Mail Address Cily Statc!Zip Phnne <br /> Lti\C,�—,Z N t C.C��� ��� - -- <br /> Slafe Lir,ense Number ' Contr�icl f'rice o(Vdork <br /> Proposed Usc ol Buildin� Conlact Person (Plan Review) <br /> Dos��)ion of Work to Bc bonr_: �\V �(�.��.,L� \ U�)�,��'�U��� <br /> ,�i I ZL�U <br /> NOT�: 4VIRING IN NON-DWELLINGS IS REQUIRFD TO FEE <br /> BE IN RAC[WAYS, MC OR AC CA�LE. � � l �'` <br /> � v <br /> � <br /> � CITY OF EVFRETT LOCAL SALES TNC CODE IS 3105 <br /> 1 heroby ce�ti(}�that 1 have read nnd examined this applicafion ivnd kno�v the sarne to be Uue tmd <br /> cerrLct. All provisions ollaws and ordinances go�-emmg fhis type�o!norl� �eill be complefed <br /> �rhefher spca6ed heriin or noL The granfing o/s pemiit dees not nesume to give aufhcnty to <br /> violate or cancel ffie �rovisions o/nn}�other state erlecal la�v regulntinp construcfion or fhe <br /> perfonnance o(cons�niction. lhnt 1 am aufhaized 6}�(he onner o!fhis pruperty to pe�fomi Iho <br /> �vork ler�vhich application is made and I comply n�ifh the State Confractors Law 18.27 RCW nnd <br /> 29�.200 WAC. <br /> T��-���,�r-� ,: _4,_-�-------—y�#a�� ' C� <br /> �=c�o4-as� <br />