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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 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ' • �[ � �/1 J/ iN il L�� <br /> PROJECT ADDRESS <br /> ��+('L�Z �ft I� r[L�.F-���� <br /> OWnef Atail Address City Slale2ip Phone <br /> Tenanl A1ail Address Cily S�ate/Zip Phonc <br /> �`5 6�j�{'cTr�Icr1L <br /> 5'vr'l�lr fi-i4�✓IIKS Il3y iN�,�,i�;� �7k' ���' �lV,�i��c� r t/�i /��f� �2Y =�'� <br /> Eleclrical CoMraclor Mail AJdress Cily � State2ip Phonc <br /> �'S• ��'�-�_ �c`� <br /> Slate License Numbcr Contr ct Price o(Work <br /> Proposed Use of Building Contacl Person (Plan Review� <br /> Descriplion ol Work l0 6e Joni�: G/Cr���Al�- ��i'I��t'I r n�1'��n��rL /%�� �X�51 i A,��' �'� /ti <br /> f ti1 H FX'1-'�/iZ(i 5 7� /L�/� l4s� 73� FU2%zSC�n.'i' N� -/�/7`� UCNTS _ <br /> NOTE: W IRING IN NQN-D'�1�ELLINGS IS REQUIRED TO FEE <br /> BE W RACEWAI'S, h1C OR AC CADLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � y/ <br /> 1 hereby certi/y fhaf I have read and extimined fhis application�nd kno�v fhe same to be frue and ��"I{���y � C�� <br /> correcL All provisions ollaws anA ortiin�nces govemmg th�s type o(work n•ill be complefed <br /> whelher spea�ed herein or noL The c�ranting of a pennd does not prosume to give au�honty to <br /> violafe or cancel(he pra��isions o/any otber,5fate or local la�ro regulefing consfrucfion orfhe <br /> perfemiance o/constiuction. ThaL auf!bnzed b��the onner ol this property fo pedonn fhe <br /> work!or�vhich anplicafion is madc+and 1 c�iply�rifh(he Sfate Contracto{� Law 18.27 RCW and <br /> 296.200 AC. „ - <br /> �� � ! <br /> �' , / � � <br /> I ���� � � C• <br /> C Srmalure / Dale <br />