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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERFTT PERMIT SERVICES <br /> 3200 CEDAR S"fREET, E'VERETT, WA 98201 1 " � `�� <br /> 425-257-8810 - FAX 425-257-8857 —v�nvw.everettwa.org G�/I ��6 5� <br /> G <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ' vZ� � I�I-1�i �- S ��U - <br /> PROJECT ADDRESS <br /> � ��L\ � � iJ�L �c� �a `� 1 Stale/Zip Phune <br /> Owner 1�1aii Address Ciry <br /> Tenant Mail Address <br /> City Stale/Zip Phone <br /> t.�:�� <br /> ��.t,L<Z� LTLTu2-�C 1 ���:� � 1��c1 f-IJE� Nt irin Jil UJi� `"(c�Z-�� Phone <br /> Electricai Contractor <br /> Mail Address Cil/ Slate/Zip <br /> � c�on �` <br /> '���-�L � L��Ci�!��S Contrect Price of Work <br /> State License Number <br /> Contact Person (Plan Review) <br /> Proposed Use of Building <br /> Description of W ork to Be Done: -�l�1 L l��� ��F'�-iC�L L — <br /> NOTE: EIRIN RAC:EWAYS MC OR AC CAB qUIRED TO <br /> FEE <br /> CITY OF FVERETT LOCAI SALES TAX CODE IS 3905 <br /> 1 hereby certily lhat I liave read and examined this application and know the same to be true and �1�\� —��j� <br /> correcL All provisions o!laws and ordmances goveming this typo o(work will 6e completed <br /> �rhether specilied herein orpot The granting o/a pernut does not prasume to give aufhonty to <br /> violafe or cancel fhe pr�visrons of any other state orlocal law re�ufehng construchon or fhe <br /> peilormance o(construction. That I am aufhonzed by the owner o/Ihis property to perform the <br /> �vork lor which application is made and 1 comply with the State Contractors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> _ _ _ <br /> -- �—` �� �j/li'rSf ZCi�� <br /> _ Date � <br /> —��_ _� <br />