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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET�I , WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.evereltwa.org <br /> APPLICAI'IONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> G�o ��- Fo ��i vi�✓ �;2 <br /> PROJECT ADDRESS <br /> �iL����.�E /�e.N9��z 2�i �Z rorcc3Tv,c-1� �iz Lv���etrl/�A �i��as <br /> Owner A1ail Address Ciy� Slale.2i, Phone <br /> Tenant A1ail Address Cily Stale/Zip Phone <br /> 1�1_l�ElUo('.I<S - IIa� Z�� SUfW-Wo���k�� �/r�2L13 tSoT}-�Ez��WA�18a11 �1Z52i� vi5`I <br /> EloCirical Conlraclor Mail Address Clry Stale/Zip Phone <br /> W/�Z C VJE._i`� fl�(�-fI <br /> State License Number Conlracl Price o(Work <br /> Proposed Use of Buildin� Conlacl Person (Plan Review) <br /> Description of Work lo f�e Donc: R������= !-�C �S n/�� �f�i�C�— �J�ZJ C� .SC.�✓%�!- <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 3705 <br /> 1 hereby certily fhat 1 have read ond examined this application and kno�a the same to Ue frue and ��OC _ '�� <br /> correcL All provisions oI la�vs and ordinances govennng fhis type o(�rork n�ill bo completed <br /> whefher spea(ed herein or noL The granfing of a pemuf does not presume fo give authonfy fo <br /> violafe or cancel the Provisions o(any other sfafe or local la�v reguleting wnstrucfron or fhe <br /> performance o/constniction. That 1 am aufhonzed by fhe ouner o/fhis property fo pedemi the <br /> �vork for which application is made and 1 cornpty�si(h the Stafe Controctors La�v 18.27 RCl1�and <br /> 296.200 WAC. -, <br /> �; � /'� <br /> ' :� <br /> / <br /> �=�-�i�!J����CG�L�C � - l 7� � � <br /> i <br /> 'Sipnature Uate <br />