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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 425-257-8810 - FAX425-257-8857—www.everettwa.or8 L 09DO5� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />Mail Address C'ry <br />Statefbp <br />owner <br />Tenant Mail Address <br />City Slatoizip Phone <br />r/-1 V, I ece <br />i% Sc' � <br />city <br />Electril cdrese�ily�C1 <br />rtrr o� (FSc3 `ht F <br />State License Number <br />t <br />j(.' c f �r' // i 1 <br />Proposed use of Building <br />D1 <br />Phone <br />t 44n ..StJJaty��(L//jtj nab 6 <br />Ste' <br />Contract Price of <br />ofWork <br />_,TLs_o_ G� Se U r_+ <br />Contact Person (Plan Review) <br />NOTE: WIRINGE IIN RAC WAYS MC OR AC CABLE. <br />UIRED TO FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3103 <br />coireY Alfrtp ovhsions o�leivs end o dmances gtivemmlg fh s type o, w d< vill be completed end <br />whether Apecthed herein'a not. The grenbn or a permd does not presume to give euthonty to <br />violate orceci the pro visions of anyotherstateorlocal!ewregustingconstrudtonorthe <br />performance o/construction. Theft am authorized by the owner of this property to perform the <br />work for <br />which cons efion n made and !W mply with the Sfete COn!rectors Lew 16.27 RCW end <br />296.200 WAC. <br />F 0902- 050 <br />