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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 `/— � 7 ` �' � <br /> APPLICATIONS AFE ACCEPTED FROM 8 AM TO 4 PM �L?--�`;�?_ �C%C' <br /> � - C= U{'.� ' �, �,v � �V� �2.�t w��, �.8a�3 <br /> PROJECT ADDRESS <br /> �lUic�. �.�r'1 �2c,{�) �cl�-�5�'1 <br /> Owne� tdaii Address Ciry Slate/Zip Phone I <br /> LJ CL.%��� <br /> Tenant Mail Address Cily Stale/Zip Phone <br /> � Vl�v{�� � I�.c�_c,c, ��C - I`d�� 3"l� �9��C S.L- 1X,7t2e.� 1,5�1� 9�'0l2 <br /> Eleclrical Contraclor Mail Address Cily Stale/Zip Phone <br /> �v`�3`�3' <br /> (���s�I�J z9��D� . ,�i�,a�c� _ <br /> Slate License Number Conlract Price of Work <br /> �-��:�ic_t�-� <br /> Proposed Use o(Building Conlacl Person (Plan Review) <br /> Description of Work to Be Done: (�(l�� C�`��L'�'�1 S �ll�c .• b�CX� �'M����Cl,�c,SZ _ <br /> �kDU� ( '��'n�)��;�_� (',�Q�'���a. fi�ie R�e�FDT�c� �-�, �VF�C.- <br /> ,—; " v <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 1 have read and examined Ihis applicafion and know the same to be true and <br /> correct. All provisions ol latvs and ordinances goveming tlns l ype ol woik will be completed <br /> whefher specified herein or noL The granfing o/a perrmt does not reswne to give authonry to <br /> violate or cancel the provisions o(any ofher state orlocallaw re�uPting construction or the <br /> perlormance o�construction. That 1 am aufharized by the awner o!fhis properiy to peAomi the <br /> work lor which application is made and 1 comply with the State Confracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> —Q %�,�,-- �� ���d�� <br /> � SignajuFe�� Dat� <br /> � � � ' � c-7c 1 —�v� <br />