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ELECTRICAL PERMIT APPLICATIAN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, NIA 98201 <br /> 425-257-8810 - FAX 425-257-8657 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> �ZL_�� �� ��� �,���-�, �i�� Y <br /> PROJECT ADDRESS � <br /> �1 i <br /> /7/�/t�`G� �/i S/� J���7'�� <br /> Owner Mail Address City State/Zip phone <br /> .L�//l���i C�%"15N <br /> Tenant Mail Address Clty Stale/Zip Phone <br /> � yl � <br /> N�a�� ,vs.���.-, 1��� �vo� ;��� sE �1�,lGC/1.�/� �>}�v>L ���-�,��� <br /> , <br /> Electrical Contractor Mail Address Gty State2ip Phone <br /> l��'i5 S T�'S 9�/ IZ ,�1 .�SD � <br /> Stale License IJumber Contract Price oi Work <br /> Proposed Use o(Ruildin8 Contact Person (olan Revicw) <br /> Descnplion of W ork lo�e Done: .1!�I S-�J4/� �1L t��C �(2/c iC �5 i�;Lj' <br /> NOTE: WIRING IN NQN-DWELLINGS IS REQUIRED TO FEE I <br /> BE IN RACEWAYS, MC OR AC CABLE. I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily Ihaf lliave read and exantined Ihis�ppliealicn and know lhe same to be true and I <br /> conecL A/l provisions of laws and ordinances govemmg tf�is type o/work n-i(1 be completed <br /> whether speci/icd herein or noL The granfing ol a pennit oces nof presume to give aulhonty fo i <br /> violate or cancel the provisions ol any other;tate or local law rcgulsting construction or fhe <br /> perlomiance o/construction. Tliat 1 em aufhonzed 6y the owner o/fhis propeAy to pedortn fhe ' <br /> work lor which application is made and I comply with the Sfate Contracfors Law 18.27 RCW and <br /> 296200 WAC. <br /> � <br /> � � �•-. i0/���6 _ i <br /> $ ure Date <br /> kl:'uIC' � 5`J <br />