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EL�CTRICAL PERMIT APPLICATION <br />CITY G�F EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICAl'IONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />•j —7 . , —� <� 7 � � <br />. � , � !. � ;.�.� <br />PROJECT ADDRESS <br />;, <br />LC�(1nCIl� ..������ �i��� `�5�:'. ��i �qfb.. <br />�` /.i <br />Owner �.�a�i Address <br />� <br />ci;':�c�Gr, ;c;� '��:itJl `/�S""> i_i�hS�C <br />Cit7 State/Zip Phor�e <br />Tenunl �� t�il AdJrosc City Slale2ip Phone <br />,/1r�7�N.iLl, EI.LCTI?(L �7/`/ 95�r� .4JZC' /✓,::� L/'�� ti,� t '� `>���:�-�' '/?s`:i%�—?f2G <br />� /-e. ✓; i <br />Electrical Conlraclor Mail Address City State/Zip Phone <br />/: � � <br />��1�-/v�,(�.�"'"j �.;;�/Ic <br />Slate License Number <br />�-�_/' <br />Proposed Uso of B��ildiny <br />Descriplion of Work to [3c Dono: `�-� � �- '� ���� _ - <br />NOTE: I�dIRWG IN NON-DWFLLINGS IS FEQUIRED TO <br />BE IN RACE�NAYS, MC OR AC CABLE. <br />L��'�j� i:_; <br />Conlract Price of Work <br />Cont�cl Person (?lan Revicw) <br />r <br />/ . ��y�� `yC. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily that 1 have read and examined this application and kno�v the same to be Vue and <br />ccrrecL All provisions ollaws and ordinances governmg this lype ol work wi116e wmpleted <br />whefher specilicd herein or nol. 7he granting ol a permd does not uesume fo give aufhonty to <br />violafe or cancel lhe provisions o/any other stafe orlocallaw regu�atin� cunstrucfren or the <br />peilormance o/ construcbon. That 1 arn authorized by the o�vner of this properl}� to perlorm fhe <br />work lor which ap ation is made and 1 comply �.i(h the State Contractors La�v 18.27 RCIh' and <br />zss.zoo wac. 9 � <br />/� <br />-.�-�� -�� <br />FEE <br />�� ��- ' -l�� <br />