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( <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRtET, EVERETT, WA 98201 � aO —��� <br />425-257-8810 - FAX 425-257-6857 - www•everettwa.org � <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />� Q i �; (nJ�7�"1.�tiu/F �d P <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />02� Z� c�,� f��� �h�� <br />Mail Address ��b' <br />Address <br />City <br />�.r.��T w� r- <br />State2ip Phona <br />S�ate2ip ������� <br />c✓ <, 7�7e� h��� Y3�L ��z �`�' /f�' /'`1���,r� ,�/� l,�,� 96�s-z �'ids <br />Cit Slale/Zip Phone <br />Elect ical Contracto� Mail Address Y <br />// ��f' � �iS". w <br />�J�� l I e� ` Y`� /�� Contract Price of Work <br />State L cense Number <br />� <br />Proposed Use of Building <br />Square Footage Qi residential new construclion, remodel or addition) <br />�� L�1�/ICC l � <br />Description of Work lo Be Done: <br />✓G� f��N, ; T`� /1� ( Z vb' -c� Z � <br />NOTE: ERN RAC WAY3 MC OR ACI CAB 4UIRED TO <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 here6y certily that I havo read and examined this applicafion and <br />rnrrer.t_ All nrovisions ollaws and ordmances goveminy fhis fype <br />:� <br />i / <br />� <br />N�Gw <br />Contacl Person (Plan Review) <br />iow fhe same to 6e frue and <br />work will be. completeC <br />asume to grve authority to <br />ing conshuction or Ihe <br />iisp rope .y to pedorm the <br />actors Law 18.27 RCW and <br />��, <br />FEE <br />�lac� - D�S� <br />