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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 - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />�;�7`� I � 3� l�r `.� C <br />PROJECT ADDRESS <br />OWllef <br />�— <br />Tenanl <br />Address <br />Mail Address <br />� V� <br />Cily <br />Cily <br />Slaic/Zip <br />SlatelZip <br />yZ1 <br />-�`�� � �C7C' J'7� <br />Phone <br />Phonc <br />�j l� 0 <br />�ioNHe�_s�N �� 104 S.QLu��,o�c. r�It�.IT W� . 43s- ���Z� <br />ElecUical Conlraclor M11ail Adtlress City Stale2ip Phone <br />_1)onne_c ��DyypZ <br />State License Number <br />SF� /�17� j IU�.( <br />Proposed Use o( ildin� <br />Description o( Work lo Be Done: �ti //i �.J <br />� <br />ZSUo. G' O <br />Contract Price of Work <br />J�M <br />�iJUUe�.CI �� <br />Conlact Person (Plan Revicw) <br />(pr��,y � C65'J3-6o5- ` <br />NOTE: WIRING IIJ NON-DW[�LINGS IS REQUIRED TO FEE <br />BE IN RAC[WAYS, MC OR AC CA4LE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify Ihaf I h�ve read and exandned fhis application and know the same to be fnie anA <br />co�recL All pravisinns o/ laws and ordinances govermng fhis fype o/ work u�ill be cornpleted <br />�rhether speaGed herein or noL The gran(ing ol a pernu( does nnt resume fo give authority to <br />violate orcancel fhe provisions ol any olher stafe orlocal law re�uPiing construcbon or Ihe <br />perfomiance ol wnsfrucfion. That I arn aufhorized Gy the owner o/ this property to pe�form (he <br />work !or which application is made and I cornpty �rifh the Sfafe Contracfors Law 7827 RCW and <br />