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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERET7 PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 Z_i c� _p-g <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org � <br /> L�O g0 2 -/�S <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � 9�� C���, � <br /> PROJECT ADORESS � <br /> �.� ��i�� �-�� �L�j �� S /�o ��4- �d � <br /> OWner Mail A_d!ess Clly Stale2lp �� !� �P�hone <br /> �9 d <br /> T" <br /> ���GL ��va�h ��� � ` �� �� o?O l <br /> nenl Mail Address Cily State/Zlp Phone <br /> ����/�� - <br /> Electrical Conlradof Mail Address Ciry Slate2ip Phone <br /> ,.d <br /> �L j� / 5.��2/ 7����i�/� � 171� <br /> Slate License Number Conlra t Pnce of Work <br /> �'�lc� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> /� � � W"�// /U W � <br /> Doscriplian of Work lo Oa Done: ��— OHTCII��e 1y��1 ��� � I <br /> �,�,/� ���i�� � D � d�- D Q - <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CALiLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I heroby ceriily(haf 1 have read and exarnined this applicafion end know the sasie fo be fruo and <br /> correcf. All provisions ollaws and orclinances goveminc�fhis fype ol woAc will 6o wmplefed � <br /> whether spealied herein or noL Tho granfing of a pennd does not presume fo give aufhonry lo I ) <br /> violafe or canccl fhe provisions o!any ofher state orlocal law regulsfing construction or fhe � � <br /> peAormance o/consfniction. Thaf I am aufhonzed by the ownor ol fhis property to perlorm Iho ��. <br /> work/or�vhich ap Nicefion is mado and 1 compty wifh the Sfafe Confracfors La�r 18.27 RCW end / � <br /> 296.200 W . _ �� <br /> l (/ <br /> �— �-7���c� <br /> ign /uf� �Date <br /> C�- <br />