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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERPe�IT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 $_at}...Q(� <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org ��g_/�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ZZG �l 8'" � '��' <br /> PROJECT ADDRESS <br /> 2Z5 ���*'� 5�1-5�,� <br /> k���,����-, r9 EII;�+? C.,� ;��1- 1n�1� �t�zv� Kzsy��2�� <br /> Owner Mail Address City Stale/Zip Phone <br /> Tenant Maii Address City State/Zip Phone <br /> �C' I� <br /> Electrical Contrac�or Mail Address City State2ip Phone <br /> State License NumbP� Contract Price of Work <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> DescriptionofWorktoBeDone: �c'>V1UQi� l'"� � 1"�� �a:�1=rF�s �Gf��L �� ���� <br /> / <br /> S�. .J '.n C'�v�C� �n ��VV1 t I � � � f�ti' 1 <br /> NOTE: WIF;ING IN NON-DVJELLINGS IS REQUIRED TO FEE <br /> � BE IN RACEWAYS, MC C' AC CABLE. <br /> f <br /> ClTY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i 1 hereby ceRi(y that I have read and eaamined this application and know the same fo 6e true and , <br /> correcf. All provrs�ons of laws and ordinances governing this type ol work will be complefed <br /> whether spea6ed herein or noL The granting o(a permit does not presume to give authonty to <br /> violate or cancel the pmvisions of�ny other sfate or local law regulafing construchon or the <br /> per/onnance o/constructron. That 1 am authorized by the owner o/th�s property to peAorm the <br /> work lor which application is made and 1 cornply with fhe State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ( (\ <br /> )� �-��,�,1 1 � -ZI - oS - 3 <br /> Signature Date � ` <br /> '� <br /> V��� <br />