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I ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> I 3200 CEDAR STREET, EVERETT, WA 98201 c���, _/ 2 <br /> 425-257-8810 - FAX 425-257-8857—www•everettwa.org G /�(��f�' <br /> 2S Z5 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I I <br /> I ` <br /> ����� � �i '� � / 1� '( �Ct���'_ �� <br /> PROJECT ADDRESS � ���5, �Ji. , � <br /> � <br /> ) � r ' <br /> � w <br /> � /����,; i���� ��i�� t.�_ :, ,- ;� �� -;� ;��, ��/� /,{':-i� i . . <br /> ; ` � <br /> ' Clty Slate/Zip Phone <br /> Ownef Mail Address <br /> � i� � 1 � ! ��� '� !`i � � � �i , � S ,� /_ ,L—�ie�r�%� l t//� �14��,/ 'i�i �'i S'���, ��� 7 <br /> � IMailAddress Cdy � State2ip PhO� <br /> Tenanl j ' <br /> � �� � � h���i � " -, <br /> IV� I���� J:< S�S i�/: <br /> ,, , ' ,i7� /-i i, S/r i N l �� Ar� ,' �/�,2, <br /> ElectnCal Conlractor Mail Address <br /> Cily SlalelLp Phone <br /> / ;-- <br /> >���C <br /> r <br /> ���`�- ��� I'(� ` � > i "�� �� Conlract Pnce of Work <br /> State Licens'e Number <br /> � l i <br /> �•`'�� �"�' �' Contact Person (Plan Review) <br /> Proposed Use of Building <br /> ISquare Footage pf residenUal new construdion,remodel or addilion) <br /> !i <br /> / � �� -�� / ' ro ti� <br /> Descnption of Work to 8e Done: I�_�����1�� � ��' � ' / � � <br /> � <br /> �I <br /> IIFEE <br /> NOTE: B IRN RACEWAYS MEC OR ACICAB�UIRED TO <br /> �' CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heroby certdy thal 1 havo read and exarnined fhis applicafion and know Iho same to bo frue and �I �U�' — (J�� � <br /> correct A!I provisions o/la�vs and ordinances govemmc�Ihis fype ol work�»ll Ge complefed <br /> whefher specified herein or noL The granfing o�a permd does not rnsume fo givo aufhonty fo <br /> wolafe or cancel fhe P���sions oI any othor sfa(e or local law reguPling consfniction or the <br /> peAo�mance ol conshuclion. Thaf I am authonzed by Iho owner o/fh�s propeAy fo peAomi fho <br /> work loi which applicafion is made and 1 compty�vifh(he Sfa(e Confrac(ors Law 18.27 RCW ond <br /> II 296100 WAC. , <br /> . <br /> �� <br /> ,� ;— �� tu,�. �/iv� ao� a <br /> � �a� <br /> Signaturu- <br />