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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —�v�vw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> ��� {�ta I N� ��VC�.. <br /> PROJECT ADDRESS <br /> ���}t� �,��,� h��, �32� ��,::� r�..� �ti�,rt+ i,,,� �Yw� ' <br /> Ownef �7ail Address City Stale/Zip ?hone <br /> �l �6S C-�,�I�c� pr� 's� 332G �n�rHc ��-aC �-vt.�e ('{- W (a- 'FZ5v2f7-9d'ac <br /> Ten3nt htail Address Cily Slale/Zip Phonc <br /> L'7�/N-t—� <br /> Electrical Coniraclor Mail Address City State�Zin Phone <br /> Sla�e License Number Coniract Pnce of Work <br /> �� E,piCi <br /> Proposed Usc ol Duilding Conlact Person (Plan Review) <br /> Description o(Work lo Be Done: /�'�'/�'W-��` ' "rye/ <br /> � <br /> NOTE� WIRING IN NON-DW[LLINGS IS RFQUIRED TO FEE <br /> �[ IN RAC[WAYS, MC OR AC CAOLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 f n�C�� 11LI <br /> 1 hereby ceriily fhaf 1 have read and exarnined this application and know the sam�to be frue and i <br /> cerrecf. All provis�ons ollaws and ordinmtces c�ovemin�fhis fype oI o�ork will be completed <br /> whether specdied herein or noL The granllr.g o!a penm(does nof r�resurne fo�ive aufhority to <br /> ciolafe or cancel fhe uovisions ol any ofher state or local law rec��dafing construc!ion or fhe <br /> peilonnance ol cons�nicfion. Thaf!am authonzed by Ihe omner ol this pmpert}�to perform the <br /> work(or which application is made and 1 cornply�rifh fhe Sfafe Contrac�ors Law 18.27 RCW and <br /> zss.zoo�vac. <br /> �,����, G�--�� ��/�� � - <br /> Signaturc Uatc <br />