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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 5. <br /> 3200 CEDAR STREFT, EVERETT, WA 98201 C( �-�� <br /> 425-257-8810 - FAX425-257-8857 -www.everettwa.org �.o5.0�I--�ZZ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ; ��C� �✓c��!-�UJA u, <br /> PROJECT ADDRESS <br /> �i��;� a �'���q,��� �,�� ��r''',��:,�F. �,,�7�,/J� �/�/, qY��� <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address Ciry Slate/Zip Phone <br /> ( /4 f �/c r:c <br /> Eleclrical CoNraclor Mail Address Cily Slate/Zip Phone <br /> Slale License Number Contracl Price o(Work <br /> � <br /> Propo�d�e of Buildinc� Contact Person (Plan Review) <br /> � <br /> Descriplion of Work lo Be Done: h �v:�l 'q' S���C <br /> � <br /> ��19" 7 <br /> NOTE: WIR';JG IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BF. iN RACEWAYS, fV1C OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf 1 have read and examined fhis application and know fhe same fo be true and <br /> conect. All provisions ol/a�vs and ordinanees goveming tlus lype ol�vork�rill be complefed <br /> whether specdmd herein or noL The grantiny ol a pernut does nof resume to give authonty fo <br /> violafe or cancel lhe provisions ol any ofherstafe or local law reguPfing construchon or fhe <br /> per/omiance o/wnstrucfion. T4at 1 am authonzed 6y the owner o/tlus property lo perform fhe <br /> woik!or which applicafion is rnade and I comply wifh fhe Stafe Conhacrors La�v 18.27 RC W and � <br /> 296200 WAC. <br /> � � V <br /> ��j����iti:'l; �-����-JS� �� � <br /> �SlgnatT�u e �� /) Date � <br /> , <br />