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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 /> ,,� <br /> APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � ��.f}�.c�/l�✓ <br /> � <br /> PROJECT ADDRESS <br /> C��'S ��1/r'���-1.--5 ����`� ��r,�q w��s fr'F/ef� w.9- 9�,�oi <br /> Owner Mail Address Ciy� Slate2ip Phone <br /> f e,�1�� �;'�.s�,�rrc�- ��iSit <br /> Tenanl Mail Address City State/Zip Phone <br /> �"1�9 -,� '� 0� l � 6! / <br /> SiG ti �T .1�� % isi� Freew�� �rT ��ei��� k-�- 9�� 3 ��ss <br /> EleClrical Conlractor Mail Address � Clly State/Zip Phone <br /> S>�G�t��t � * 9S qc6 z, a� <br /> Slale License Number Conlract�rice of Work <br /> i7CC �// 7C�T����{ � <br /> Propose Use of Building Contacl Person (Plan Review) <br /> Descnption uf Work to�e Done: �!>S j.������t/ <br /> NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO FEE <br /> [3E IN RACEWAYS, MC OR AC CABLE. <br /> j CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> l hereby cerii(y fhat 1 have read and examined this application and know fhe sarno to bc Uue and <br /> correcL All provisions ollaws and ordinances govenunc�this type ol work n�ill be complefed <br /> whefher speafied herein or noL Tiie granting of a pennd does not presume to give authonty to <br /> violafe or cancel tlre provisions ol any other sfafo or local law regulating construcfion or the <br /> perfominnce ol constni fion. Tlm!I ant authonzed 6y fhe owner o/fhis property to perfomi fhe <br /> worR(or which ap li�i is mude and 1 comply wifh the Sfafe Confractors Law 1827 RC W and <br /> 296.200 W.4C.� � <br /> / / ��� �/�7�1 <br /> / SignaWre � te <br /> FvCni( -IUS' <br />