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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.everethva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />150'� 50-�-�` � s� : <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Electncal Contractor <br />Mail Adtlress <br />Mail Atldress <br />. , ( e �,r�%�Gl�t`�'�� <br />Stale License Number <br />S� Q <br />�rcpnseA Use of�udding <br />De.ss��ption af Work to �e Done. ��-�� <br />Ciiy <br />Cdy <br />�i, a3-�3 <br />E�3�'l��z� <br />�!a s <br />SlatelZip <br />Slate2ip <br />Phone <br />Phane <br />,h �L .."�-��t l.�ct �� �I��; <br />Cily � SlatelZip a�,. al+ �• Phone <br />"}l� CO <br />��� <br />Contract Pnce ol Work <br />`Aa Y�f1.M--�- <br />ConlaU Person (Plan Review) <br />NOTG WIkfNG IP! NON-DWEI_LINGS IS REQUIRED TO FEE <br />BF W flACEWAYS, 11C OR AC CABLE. �11 d� <br />V <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ----� <br />I hereby r.ertdy Ihat 1 have �cad and examined fhis applicafion and know fhe same to he (rue and � j� �� I�� <br />conecf All provisions ollaws and ordinances yoveming Ihis (ype ol work will be rompletcd � <br />whelher spr,ci6eU herein or not. The 9ranting o! a perrrid dor.s nof piesune 70 9ive a�dhority fo <br />vrolafe or cancr,l fhe p�ov�sions o! any ofher sfafe or local law regu/ahny consVuc6on oi fhe <br />pe�formanr.e ol conshucfion That 1 arn au(ironzeJ by 7he owner ol lhis prope�ty fo poAo�m fhe <br />woiJ� lor which apphcohon is rnadr. and 1 comply wrlh fhe Slafe Conlractors law 1H 27 HCW and <br />256.200 WAC. . <br />V <br />I-- �—� — — - -- <br />