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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.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> a <br /> - ,��� � ./�.���� ��' ' �� "� <br /> PROJECT ADDRESS Naf'3,`Q" C/�7 Z <br /> I <br /> �� , �� ����' ��/�� //�r ���'/ <br /> �'��' � � ��� �a��� f � /�' <br /> 1 Owner � A�) II A drees Cly Stete2lp Phone <br /> �r.�;G �� ��' � �.1�' �� �U,��� yf 3`��� � <br /> Tenant Mall Address <br /> Clry SlatelZip Phone <br /> > <br /> � �� � � � � �/�/��/, ' ,/' /f%,!� ,? � <br /> Electn�Cantractor � �Mail Addrees C�ty Slate��� ����� 3honn� O (� d <br /> �,��o y z ,��� s � <br /> State I.Icense u er Contract Price af Work <br /> Proposed Use ot Building Conlact Person (Plan Review) <br /> DescripUon of Wark to Be Done: � � �"l � � � L �`�r� <br /> - �/< � � �� — <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 IS 3105 <br /> I hereby certily that I have read and exemined this application and know the seme fo be true and <br /> wrrecL All prov�mons ol/aws and ordmences goveming this rype c/work will 6e completed <br /> whether specd�ed herein or noL rhe granting ol a permrt does not presume to grve aufhonty to <br /> wolete or cancel the provlslons ol eny ofher state or local law ragu/eting construcfion or the <br /> peAormance ol construct�on. 7hat!am eufhonzed by the owner ol this property ta peAorm the <br /> work Ioi which application�s made and I compty wlth fhe State Contractors Law 18.27 RCW end <br /> 296.2001yA G. <br /> IL." ,� �d/���� � � I <br /> �� Sipnawre � e rl / I <br /> �� �V) <br />