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1'S�c;����- ��� , , <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVIC�S <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 -www.everetlwa.org <br />APPLICATIONS ARE A(:CEPTED FROM 8 AM TO 4 PM <br />�`% '� �J � <br />� I i v IJ(vc_[I(�r,�/ 5� �L /U � <br />PROJECTADGRESS <br />�'1 , ��- /�'1 ,�_ �c1 �� Z�G 7�' `� `�ll 7 <br />OWne� IdailAddress City Stale2lp Phone <br />�� �� <br />Tenant Mail Address City Stale2lp Phone <br />�� ScJ�.Q ���Q�fYiL <br />COnlractof Mali Addross <br />-��,� �� �� az� ps <br />Slate Lice se Number <br />(���W�•��,�.H� S\�%i�L' <br />Proposed Uso of Ouilding <br />Description of Work lo Bo Done: <br />NOl L: i,NIRING IN PJON-0WELLINGS IS REQUIRED TO <br />I3E IN RACEVdAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE I5 3105 <br />I hereby ceAily fliaf / have read <br />conecL All provisions ollaws a <br />�rhefher spea(eA herem or nof. <br />�iolafcorcancelOtc provisions <br />perlomrance oI �aisfruclion. 17 <br />�sork tor which applic�fion is ma <br />29610014��L'. <br />CIL•� <br />ti� <br />�mined fhis applica�ion and know the se <br />iances �ovemmy fhis type o( work wi/l I <br />anfing ol a pemut does not �resumo to <br />dher s(aro orlocal law re�u��finr� rons6 <br />� aufhaizeJ by tfie o�rner o/ this propen <br />1 cornply �ti��th (ho Sfafe Cen6actors La� <br />��-,`T <br />2cG j 7/ - <br />Stale2ip <br />� v�� <br />� <br />Contrect Price of Work <br />Conlact Person (Plan Review) <br />Q_c..��:� c � 7C��.�.'S <br />� fo be truo and <br />complefed <br />�e authonty to <br />'ion or fhe <br />� pedurnt 1he <br />8.27 RCW and <br />iu <br />fEE <br />CI��-�z3 <br />Phone <br />