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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.everettwa.org <br /> APFLICPTIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> l 17� � r� w�- � 9 '� <br /> PRO.;ECT ADDRESS <br /> .�fn/,v y /'✓1i4 ! �-f l S��l % ;i 'T <br /> Owner Mail Address ' Cily State/Zip Phone <br /> L ��c c K 5 C l� C (/��N �v l <br /> Tenant Ma!I Address City State/Zip Phone <br /> �. C- �� Irc�SoN C«tl;'� C ln1C 53�-2 � 32 ".1 s'� -S �'�/ L �(NN;�cre:� <br /> E�ectrical Coniractor Mail Address J Ciry Slate/Zip Phcne <br /> r (' J ��/�'� � <br /> � 2 � <br /> _� C r��� � �: � o $ c <br /> Sfale License Number Conlract Price of Work <br /> { S 5 %i9TrvN <br /> Proposed Use uf Building Conlact Person (Plan Review) <br /> '� Description of Work to Be Done: "�'�"5 r�{'�--�'`� C"�Nv�"�' J vU�,�NEA tl SEJ�✓<<� <br /> n / 1� /t'E�/� � <br /> I O LCN�L t�� M1�;�n�F� SL�✓�c� i �LU �_ 5 I i D Z`'ij 'Y l �" � <br /> 3 - : �� A �G �,�,.� S. <br /> NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABI.E. /l 11Fi � <br /> `7��-�t.� <br /> CITY OF EVERETT LOCAL SALES TAX COJE IS 3105 <br /> I hereb�cerii(y that 1 have read and examined this applicalion and know the same fo be true and <br /> correcL All provisions o/laws and ordinances c�overning this type olwork will be complefed <br /> whefher speafied herein or noL The granting o/a permif does nof presume to give aufhority to <br /> viola(e or cancel fhe provisions o(any other st�te or local law re�ulating constn�cGon or the <br /> peAomiance of construc6on. Thaf I am authorized by the owner ol this property to perlorm fhe <br /> work(or�vhich application is made and 1 cornplv wifh(he Sfafe Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> n ,J <br /> ���� �- �{�--s- �s � <br /> Signalure Dale ���� <br /> W <br />