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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 FRON. B AM TO 4 PM � r, S—D� <br /> �� I 1 - ' � <br /> � 3�� '�.v � L l�J I�JCc �� <br /> PROJECT ADDRESS � <br /> ( �'�''`�\L.� `� �"�°cK -�t�k�� �, � �._,�_ �: � L� ' »��' 1� L�Z �. <br /> Owner Mail Address <br /> CitY Slafe/ZiP Plione <br /> Tenanl Mail Address City .. .fe/Zio Phone <br /> w1i�a� - � 1���'�L - }fl�� �� l�c` � � S� 011��..�. 1� t,v.t ���`�� <br /> ❑eclrical Cont�aclor Matl Address Cily Stale2�p i-+ Phone <br /> �Z��'� i�j�� l; — <br /> .c� <br /> G 1�.,��L�C.:`� t�s N i� - �1 L.��o = <br /> Stale License Number Contracl Price of Work <br /> -- ._ .� <br /> ` � j- (� <br /> Proposed Use o(Buddm� Contact Person (Plan Review) <br /> DescriptionofWorktoOoDone: _�_�'` ' � i�`- '�� [� � 1� �-Lc �—�J�[� ��(,,��� <br /> � <br /> � <br /> NOTE: WiRING IN NOV-DWtLLINGS IS REQUIRED TO FEE � <br /> [3E I�J RACEWAYS, h1C OR AC CABLE. <br /> I <br /> CITY OF EVERETT LOCAL SALES TAX COUE IS 3105 -�—� <br /> I here6y ceriily fhat I have read and e+aminr.d this application and know tl;e same fo be true and <br /> correcL All provisions ollaws and ordinances gorerning fhis type ol werk�ti�ill Ge comple(ed <br /> �rhether spealied herein or noL Tho granfing ol a permd does not presrrme to give authority to <br /> violate or canc, the provisions o/any other state er locallaw regulating construction or lhe <br /> performancr, ol�enstn�clion. Thaf 1 am aufhonmd by the owner o/this property fo �edorrn fhe <br /> work la�-n9rich 2pptiaretion is made and I comply�vith the Sfate Contractorc Lau� 1827 RCL4�and <br /> .2yG.200 N'AC. ' �%�� � �j <br /> -,_._ --- � - �� _��� � ����._ � �� �� �� �_��i ���� <br /> Signalme / I�a1e � - <br /> l � <br />