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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857-www.everettwa.org ��a�`,�( <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM `� I � D� •-13� <br />�z� -s� ��` s� scl. <br />PROJECT ADDRESS <br />J �, ��...� �� <br />Owner <br />� /=, <br />Tenant <br />' � (e �: � <br />Electrical Contrector <br />A1ail Address <br />Mail Address <br />Mail Address <br />/%/ �'1 �� �" 9 S � /i � - <br />Stale License Number <br />��c�i t � � !"f' s '!• . �" <br />Proposed Use af Building <br />-Si 5�-sfSCJ <br />Ciry <br />City <br />� � r5 <br />7!'� /�- � : � <br />City <br />Stale/Zip <br />Stale/Zip <br />r <br />YZ..S _ �g�; -`�c7,� <br />���ns <br />Phone <br />Phono <br />!l,•4� 5Go -Yi� s— <br />Phone �5� <br />`i S C V <br />Contract Price of Work <br />% ' /r c�,l�.c°�� N <br />Conlact Person (Plan Review) <br />Description of Work lo Be Done: �f�� �_�_ � y � �� � �� J, ��A�� �r � , �' � <br />i.c� � ,�.a- <br />ia�/� c:F�� / <br />/'/Fr,c'c' u � � <br />NOTE: BERN RAC WAYS MC OR AC CAB �UIRED TO <br />y/U��/� �oia �fo��C;��y��� <br />G. �<..lc'.�cm.s-r,f7_ <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerfify that I liave read and examined fhis application and know the same to be frue and <br />correcL All provisions ollaws and ordinances governmg this type ol work will be completed <br />whefher speci6ed herein or noL The �ranting o(a parnut does not presume fo give aufhority lo <br />violate or canr,el the provisions o( any uther state or local law regulating consfruction or the <br />perlormance of cor� catior�is n�'de ar�id�l oornplye�f� fBe State ConfractorsPLa�v 18.p27 RCW'and <br />work lor which app <br />296.200 WAC. <br />Cllo�-- l3� <br />