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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320Q CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APFLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> !f - �aU -pj� <br /> ���li -/3 S� <br /> <.j5'z.� tvr�-��-� �✓,a <br /> PROJECT ADDRESS <br /> OWne� Mail Address Cily Slate/Zip Phone <br /> ��'=�« '�-�_�. <br /> Tenant M17ail Address City Stale/Zip Phonc <br /> n <br /> �_A2..«� i,�= `I�75 ,'v.�.J. �'AC�rJcC�n ��GL. On��nr�p OR . �l27,i Sa3 �i�/• �`iN)y <br /> Eleclrical Conlraclor h1ai1 Pddress City Stale/Zip Phone <br /> Carzr�rs �- �iz5 �� 3�g, y��� <br /> State License Number Contracl Price of Work <br /> Ilc ��l�1Z I��« . <br /> Proposed Use of Building Contact Person (Pian Review) <br /> Descriplion n(Work to 13e Done: � L �N`-'{���� / �YP � Z Sic. DA N e (� L t G�,-���� <br /> � 1 <br /> �C•Cc �B,1.i ^ Gi� CfFi�. (�' r��rlL��^ I�FlNPC. . <br /> ` <br /> NOTE: WIR!NG IN NON-DWELLINGS IS REQUIRED TO FEc <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> L�� '� <br /> i <br /> CI7Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi/y thaf 1 have read and exantined this application and knmv the s�me fo be fruo and <br /> conect. All prcvislons olla�rs and ordinances goveming this t}�pe o(work will bo completed <br /> whe0ier speafiad herein or noL The granfing o/a permd does not presume fo give aufhonty fo <br /> violafr. or cancel the Provisions ol any other slafe orlocal law regWating consfrucflon or fho <br /> per�omiance o(consfrucfion. That 1 am authonzed by the owner o(this property fo perform the <br /> �vork lor�vhich application is made and 1 comply wifh the State Contractors La�v 18.27 RClNand � <br /> 29�.Z��WA�. � � � <br /> � � , �� <br /> ,.��,. /��, //� Z Y�D 8 � <br /> Sic�nature � � Date <br />