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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREST, EVERE-1 T, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettvia.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />0 V <br />PROJECT ADDRESS <br />1, n-.a 4R <br />�3 6 <br />State/Zip Phone <br />Owner Mail Address City o06 _3s-s , ! U SS <br />Tenant Mail Address <br />City StaletZip Phone <br />/-D LOSAW-J-Q r Ouu114rZ <br />City State/Zip Phone <br />Electrical Contractor Mail Address <br />Contract Price of Work <br />State License Number <br />-Q' Contact Person (Plan Review) <br />Proposed use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Description of Work to Be Done: re - e eT i <br />I e- NIL e <br />IcCWl1r4, I l� 01i11� <br />FEE <br />NOTE: BEINRAC WAYS MC OR ACICAB�UIRED TO -750 <br />G <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application ano% tir w the will be completed and <br />correct. All provisions of laws and ordinances govemmg this type/Yn I J <br />whether specified herein or not The granting of a permd does not presume to give n or the <br />to <br />violate or cancel the pprovisions of any other state or local law regulalingppconstruction or the <br />nerfo manta o/construction. That 1 am authorized byi ,; gima Cnntmrclats Law 18 perform C W and <br />