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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.everellwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��r2s� ,�� �:�� �, ,� n },�P�+►-�����z�� ? �6 -�� � -�s �, <br /> PROJECT ADDRESS C <br /> ��me� kllcc��� 2�sj � C'ctSih �� �'d S'�fi� � �r �{-1" y��g <br /> Owner Mall Addross Clty Slale/Zip Phone <br /> ��� ��� — <br /> Tonanl A1ail Address City Slale/Zlp f'Ihono <br /> "�O�l( �l_ t�F �1�`L � . . �, i � ��i ��'L etiE �f vli.�l � Q �1�1 `f SZ '� / <br /> Elecirical Conlractor M1tail Address Clly Stale/Zip Phone <br /> f� C –L'\' V._� � ���� � � �� ��jC.�C'� ��:n <br /> Slate Liconso Number Contracl Price of Work <br /> Proposed Use of Buildinc� Conlacl Person (Plan Roview) <br /> Doscription of Work lo Do Dona �u `��_i-I��C,l� --�V�N l�� �� 1 Q– �Cl� `� � � �C v ('1 � <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> �E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 . <br /> i � � � � <br /> 1 hcreby ceitdr�tliif 1 have retid end oxnntined ffiis npplication and Fnmv fho santo fo be fruo t�nA –.� •_-`-' '– '� <br /> conecL All Provisions olla�vs and or�iinances povemm�this fypo ol�roik will Ge conrpleted <br /> ahefher specilieAhaein or nof. The��milin�ot a pernuf Aoes nof presumo fo�ive nufhonty fo <br /> violafo or cancel fho uovisions o!any ofher sfafn or locnl la�v repulnfin�construcfion or fhe <br /> perionnance o/cons��udion. That 1 nrn aidhoiized by fhn o�rner o/(his pruperty fo pedorm Iho <br /> work lor whic0�pplicafion is nuvdo nnd I compty tvifh fhe Stafe Con6nctors Laiv 18.27 RCW anA <br /> zsr zoo tvnc. <br /> ` �--- — -_- ' �7 '-1 ? ? c>�.� <br /> - � <br /> slqnatuio � u �e <br /> '__ �____ �___ . <br />