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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 - wnvw everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM )_ /3 t7�"� % <br />9 8'�)_43 <br />PROJECT ADDRESS <br />scut `� Cdy StatelZlp Phone <br />Owner Mail Address <br />City StatelZlp Phone <br />Tenant Mail Address scar, <br />State/Zip Phone <br />Electrical Contractor Mail Address City <br />Stale License Number <br />Proposed Use of Building <br />Description of Work to Be Done: <br />.40 v <br />NOTE: BE IN RACEWAYS, EC OR AO CABLEUIREO TO <br />/_ fiOfl dro <br />Contract Price of Work <br />,pain.~ 8wW N <br />Contact Person (Plan Review) <br />G•rC�. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work wilt be, completed <br />whetller specirred herein or not. The granting of a permit does not ppresume to give authority to <br />violate or cancel the provisions of any other state or local law regtrrebng construction or the <br />performance of construction. That I am authorized by fire owner of this pproperty fo perlorm the <br />work f Xror which application is made and 1 comply with the State Contractors Law 18.27 RCW and INAC <br />f- 52.CO •C,C i'iGl <br />FEE <br />"��� <br />JV <br />1E13 D2-011 <br />