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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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� 2 1 �, �_ � C. � �n 0 2r� <br /> PROJECT ADDRESS <br /> Z .:�C', i� /� , �l_� C� <�r. �� �21�� �— CCc:�;w. �Z.� l�n �7Q 2C�5 <br /> OWnef Mail Address Gty StatelZip Phone <br /> 4-+�S •� �Z - S `� IG <br /> Tenant MallAddress Clty State/Zip Phcne <br /> _'-���;�� s �..� ��-, ����,.� r � c c D�t c..�rt ti �zti � <br /> EloctricalConirB (or MailAddress Clly Slate/Zip Phone <br /> ��✓�C�l<'�K'J1.1 3C.O iL$!JI Z <br /> 1��LY1.1 [c H- -h� /7Ci 1 C (' � J�� .( <br /> ulate License Number Contract Price of Work <br /> Proposed Usn of Building Conlact Person (Ptan Revlew) <br /> Descripllon of Work la Do Done�: r'���� � .. :� '� ,.. �r �-. e����� bt �..�-1-e.✓ ,�,. <br /> 4Jt �� :TY. +-i <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE 13 3105 <br /> I hacby ccrtily thaf 1 havo renAnnd exnminod fhis applicntion end know the samo fo 6e fruo and <br /> conect. �II provislons ollaws and ortlinances govendng fhis fype ol work wlll be complefed <br /> whefher spec/fioA herein or not Tho granfing ol n porrnd does nof presume fo glve uathonry to <br /> vlalafo or cancol fho provlslons ol eny ofher stnfo or locnl law regulafing construcfion or fha <br /> perlominnce ol consfruction. Thnt 1 ern nufhorized by(ho owner o/fhfs property fo perfomi tho <br /> work lor which applicn(ion!s mndo nnd 1 comp/y wifh fho Sfafe Confrac(ors Lew 18.27 RCW end <br /> 296200 WAC. <br /> — 1"�� ,i. '_ �_�'t_ � �� � ., <br /> Signalure �— Date ��� _ /,�„� <br /> l <br />