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� ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 g„a6_o� <br /> 425-257-8810 - FAX 425-257•8857-www.everettwa.org <br /> Cog���s,� <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> 3� o� c��:��� �v�z <br /> PROJECT ADDRFESS <br /> �l25 -� - <br /> Ai�,��.�1 ��) >>� �w�. E�e�e��- u,���� 3�5 3 <br /> OwnO� MaiIAUCress City Stale2ip Phone <br /> � c� WIvll � � 1 � � , ' � � <br /> Tenent MailAAdmsa Ciry SfatefZip �Z^ 2 anone <br /> S�, ��O�11P1v1 �IPLI�� . 1�1n�� I.Pnfi�'1 Y�I � �II i�a1��� �1� �� ��,�►�� <br /> EI cal Co01fa� Maii AOdresa Cl�y SlatefLip Phone <br /> s��-�-��af�S��3�5� ��o. dz� — <br /> StateLi Number ��� ryC'�11�r'ceof,l{1!of� �e <br /> ���1�1 �"� � ''' � �-f25�� 23S - �IZ."1 �' <br /> Pr osed se ol8uilding Contad Person (Plan Revlew) <br /> Description oi Work to 8e Done: 1' 1 I��N 1 �%'� 1 J '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 IS 3105 ��U�-� � <br /> i <br /> 1 herr.by ceddy that i have read and eaarmneA fhis applicafion and know fhe samo!o b�3 t�ae and � <br /> �necr. All provisiMs ollaws and ordmancos gover,vng fhis fype cf work n�dl be co npi?ted <br /> whefher specAred herein or not. The granfmg oI a permd does no!presume fo�rvN autnonty to <br /> violale or cancel lhe provisions ol any ofher slafe or local law�agelafing consiructron or the <br /> peAormance of:onsimcbort Thaf 1 am aothonzed Sy fhe o�rner ol fhis property fo perfc.m�1he <br /> work�cr whrch app4cation is matlo and I comply wit.7 iho Sfate Confraclors La�v 78 27 F'�W and <br /> 2962A9 WAC. <br /> � �ial�l�� �I � 1 c � <br /> Signature � Dale ��— <br />