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E�ECTRICAL 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 />ZSs'-. L/�-/mU�< </� � F/✓ <br />PROJECT ADDRESS <br />� -a�� -�o <br />� <br />� /C['���!p <br />�'r�. < z5.�:, ��,�s,�.,� c,.�,���-r ti/� y��a, Bs�� <br />Owner A1ail Addiess Ciry SlatelZip Phone <br />fdail Address <br />Cily <br />Stale/Zip Phonc <br />��� .� 3i z--� Err, �> � �✓,a s�z.,i PAyG <br />Eledrical Cunlraclor fdail Address City Stale2ip Phone <br />Stale License Numlmr <br />Proposed Use ol Duildiny <br />Contract Price of Work <br />Conlact Person (Plan Review) <br />Description of Work �o [3c Done: ,� i�/7 ��9�J,-� .� /�. '� � ivr � � � �?r� y �.� i'F: // <br />n <br />f'or✓�� ;., rr�� �✓,/�S <br />NOT[: WIRIPJG IN NON-DWELLlNGS IS REQUIRED TO <br />BE IN RACEWAYS. MC OR AC CABIE. <br />CITY OF EVERETT LOCAL SAIES TAX CODE IS 3105 <br />1 hereby ceriity fhaf 1 have rend nnAexamri�ed (his applicntion and kno�v tho same (o be true and <br />correct A!1 prawsions ol laws and o��iinances govemmg fhis lype o/ work ���ill be cornpleled <br />whether spealieAherein ornof. "he grantin� o!a pemul Aoes nol uesume fo give aulhority fo <br />violafe ur cance! fhe pro��isions ot aip� ofher sfale or local la�ti� regulnfing construcfion or the <br />periormance o! consfruction, That I am aufhorized U�� the on�ner o/ fhis propert}� fo perfomt the <br />�rorh In� which applic�tiai is ntade and 1 comply wdh fhe State Confiactors Law 18.27 RCW and <br />29G.200 11'AC. <br />r-EE <br />��_- 3�P%� �� b3 - /0� <br />�,,,� <br />