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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVER�TT 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 S AM TO 4 PM <br /> C:LI-�.,��C7 ��'L�.z« <br /> � <br /> 3 '� �.(, (� r��Rwuu k ��'4� <br /> PROJECT ADDRESS <br /> �. LL% <br /> �L�"'�t� 1�'L�Ati�Lt��. � ZJL ��`1� L J c.�c� �(.�/t- lf-'�7,2'`7/a= i � � �; <br /> py,�ef MailAddrese � Ci,y State/Zip Phone <br /> i <br /> �c�..,..�� �4tiV�'v�G s�..-� �a c,�-. t - <br /> Tenant MailAddress City StatelZip Phone <br /> ��Lvi'I�� � " ��/C�.S`�-.-� Ja,wt�, <br /> EleCtriCal COntredOf Mail Address Cdy State2ip Phone <br /> State License Number Contrad Price of Work <br /> i,' F7o�;,i%l,C� <br /> Proposed Use of Bui� Ing Conlect Pereon (Plan Review) <br /> Description of Wor1c lo Be Done: �_' ��vtt� O��Q�1'=- �'� `� w� �' <br /> NOTE: WIRING IN NON-DWEILINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CIiY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 he26y ceRily that I have 2ad and examined lhis application and knowlhe same to be�rue and <br /> cormct. .411 pmvisions o/laws and ordinances goveming this type ol work wifl be completed <br /> whether specified heiein ornot. The granfing o/a permrt does not presume to give authority fo <br /> violateorcancelthe provisionsolanyotherstateorlocallawregu/ating�nsfrudionorthe <br /> peAormance oI construdron. That I am authonzed by the owner o/this propeMy to peAorm fhe <br /> k�rk�or which applicafion is made and I comply wrth the State Confracfors Lew 18.27 RCW and <br /> 2ss.zoo wnc. <br /> , ,� <br /> \ ,�,u�,�,� ( l,f 16�o� � _ <br /> � � <br /> Signature � Date / �/— J <br /> C�� � <br />