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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 />9 � F7 �J L —/ i%• . � � ,; <br />Jv / ii�r �-� <br />PROJECT ADDRESS <br />,ra>Nu� � %J � <br />Owner � Mail Address <br />City <br />II �C{ �- (1 3 <br />C1,�f(��`�0 <br />Slate2lp <br />y <br />Phone <br />r j r'� C J ��-h'.� I J Phonc <br />Tenant Mail Addross <br />City Stale/Zip <br />Electrical ConUaclor Mail nddress <br />Slale License Number <br />Proposed Use of Building <br />Description o( Work lo �o Dono: <br />' � ns. <br />5ist)]n�iJ / ZIM <br />NOTE: DERN RAC WAYS MC OR ACICAB �UIRED TO <br />Cily <br />Stale2ip Phone <br />Contract Price o( Work <br />� - � . �� ��iX�9 <br />Conlact Person (Plan Review) <br />CITY OF C-VERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cer7i�y that 1 have read and examined fhis appl'9ation are o���°ork will ho�� ompleted or�� <br />correcL All provisions o/laros and erdmances govemm fhis typ <br />v o afe or�cancclihe rp rov� ior�s o! e�ny olher 9fefe or lo �latl �a 9 reguPl nq corts�frucf on o'r�the to <br />perlomiance oI consiruc6on. Tbaf 1 am authonzed.by the o�rner o/ this pwperiy to perfomi the <br />�rork lor which applicafion is mado mid 1 comply wdh Ihe Sfate Cenfractors Law 1 B27 RCl^✓ anA <br />29G.200 tNAC. <br />!� �/i �': <br />�_, <br />r <br />FEE <br />�"�-�v � �.� �� -�c�c.l3 <br />