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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT �ERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ' �' �r <br /> � L � (,'l��l'�� ��'�-��Z' w�L� <br /> PROJECTADDRESS ✓ <br /> fSf� b�r� S�� r�� �v� �� ��S�u�d�f (, S—o oA :�.,� S�� � z,o SP�,z�t%L �d��.�d' <br /> Ownef ldail Address , Slale/Zip Phone <br /> I ('�")'1\�n.�S L'L`�L ( I � 1 lljV�/1-�✓ysC` �� . .,. C1 (it//e- / �� '. <br /> Tenanl� Mail Address City State/Zip Phuno <br /> y c�' , i ) <br /> �VLII`IC'_ �� Y1 73�L I �� � 7 ri I' � 1 :� ,�� �`r�l�l�ti.�� : L✓�!_ /;/'"��/ <br /> � i <br /> ElecUical Conlraclor Mail Addrese � City State2ip �Phone <br /> INI� i���t�- >"�3 f3 I' � 3`�� � <br /> Stale License Number Conlracl Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work lo De Done: ��'UU I7 c � ��"'- f• iv— �u / � J D a� <br /> Y <br /> NOTE: WIRING IN NON-DWGLLINGS IS REQUIRED TO FEE <br /> � BE IN RACEWAYS, MC OR AC CADLE. <br /> � <br /> CITY 0�EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that 1 have read and examined fhis application nnd know fhe same to be frue and <br /> correct. All provisions o(laws and ordinances governing this type o(�vork will be completed <br /> �vhether specified herein or not. The granfing of a pemid does nof presume fo give authonty lo <br /> vielafe or cancel the prcvisions o/any other state orlocal law reguleting consfrudion orthe <br /> performance of construction. That 1 am authonzed by fhe ownor ol fhis properfy to perlomi fhe <br /> n�ork lor which applicafion is niade and 1 comply�vith fho Sfate Contractors La�v 18.27 RCW end <br /> 29G.200 WAC. <br /> � ��� � � �� � � <br /> �l � � <br /> , i , -� - il � <br /> Signalure Dato i j� � � <br /> JV <br />