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FLECTRICAL 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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� / ��i �o�i n e,r- cZ v� <br /> P JECT ADDRESS <br /> Z <br /> 1�1.�i • <br /> Owner Mail Addross City Stale2lp Phone <br /> Tenant Mail Address Cily Slate2ip Phona <br /> �' �-�,�-�S �/��, 7�� �?�s�. itl- Cr� � 4�.��-��/� �S'z�2 <br /> Eloctrical CoMraclor Mail Address City Stale/Zip Phone <br /> � �-��w� E�D� 1� 9 � <br /> ��� <br /> Sialo Lfcense Number Conlracl Price of Work <br /> �CS � <br /> Proposed Uso of Buildin� Contact Person (Plan Review) <br /> /' /' <br /> Descriplion of Wark to Bo Dono: _ /�O� ���i'���'� / � �� //` � <br /> ��rv�•c� <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��r� �-�» <br /> 1 hereby certil}�that 1 have read and exmnlnod this application ond know fhe sarno to 6o tnio and . <br /> correcl. All provisions of Imvs and orclinances govemin�fhis typo of trork ivill be complefod <br /> whefher specified herein or noL The�ranfing o/a pernut does nof rosamo to give authority to <br /> violafeorcanceltho provisionso/anyofhersfateorlocallawreguPfingconstrucfionortho <br /> perfornm�nce o(constn�ction. That 1 an>autl�onzed b}�the o�rner of this property to pe�fomt the <br /> work ior which application is n ado and/c nply wifh fho Sfafe Cen(ractors Law 18.27 RC W and <br /> 296.200 WAC. /) � <br /> � / � <br /> � / ' �(� /�" S�G�%C� <br /> ipnaluro Date <br />