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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 ACCtPTED FROM 8 AM TO 4 PM <br /> �/� z I f� I✓�/`E ,� �� <br /> PROJECT ADDRESS <br /> ! � �II Stat�'Zip Phone <br /> Owner <br /> 61m1 Add�ess �'��' <br /> Tenant Mail AAdmss <br /> Ciry Slate2ip Phone <br /> �n �}-Z vsP ��CC�/�7� !0'1ZI 9 �` P[. 1� CG�c f���n� t�.a yYZ1� ��,f'3�Z zj-77 f' <br /> City Slate Z p Phonc <br /> Elr.clrical Contractor Mail Address <br /> l�" I l�/�/ �� �l `— Q � Conlrac�r�Work <br /> Slate License Number <br /> Conlact Person (Plan Revie�v) <br /> Proposed Use of Building <br /> �escriplion of Work to Be Done: ld��— � f5�t �� ��f��� <br /> NOTE: BE�IN RAC WAYS MC OR ACICAB�UIRED TO <br /> FE'� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I h^ioby ce�iily fhaf I have read and ex.vntined Ihis.pp�icafion and know fhe same lo be L'ue�ad <br /> cen�cf. All provis�ons o(lenvs and ordinnnces c�oveming fhis fype of�voik wfll be completed <br /> �vhellmr spea�ed herein or noL The granling o(a Perrnrt does nol presume fo give aufhority fo <br /> vielate or cnncel Ihe p�ovisions o/any ofher sfate or local law regulating construction or Ihe <br /> peifo�mance o/consfruc6on. Thaf 1 am aufhonzed by fhe avner o(this property to perform fhe <br /> uvrk lor which apP��cation is rnade and 1 cornpty wilh the State Conlraclors Law 1B.27 RCW and <br /> 29G200 WAC. .. <br /> .= 1 2 I? S/G�' <br /> �� Dalc <br /> — Signalum <br /> E o8i� -la( <br />