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E�ECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 � ' �`�� <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org �Q�6-�I v <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� 7 i � G«N ;�+� v�nl � � <br /> PROJECT ADDRESS <br /> C,I+�',S Crn9�L <br /> Owner Mail Address Cfry State2ip Phone <br /> _� <br /> `� - I � - �� �� <br /> Tenanl Mail Address Cily State/Zip Pnone <br /> �/Z��- �,73 - .S/Z � <br /> ._� M H � C�� C'T(� f �. �SZZ Iclf; kl. �y SE_ � �/CS' 6cTt1Cc.� C✓A �J�3G1Z <br /> Electrical Conlraclor Mail Address City State/Zip Phone <br /> �l h,� FI E (�tL-'`t �i I M lJ <br /> Slale Ucense Number Coniracl Price of Work <br /> Proposed Use of Buiidinc� Conlacl Person (Plan Review) <br /> c <br /> Descriplion ot Work to Do Dano: f�cS i O�=�TIA<- —N£ cv Cc� 17'f�� Ci!CN <br /> NOTE: �JIRING IN NON-DWELLINGS IS REQUIRED TO FEE I <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi(y thaf I have read and exantined this application and knotv fhe same fo be truo and <br /> correcL All provisions o(la�vs and ordinances govemmg this type ol work will be complefed <br /> whether spec�fied hereni or noL Tho granting ol a permd does nof presume to give authonty to <br /> violafe or cance!fhe provisions ol any other state or local low regulating construction or fhe <br /> perfomiance of constrUcfion. That I am aufhonzed by tha o�rner o/this property fo perfonn the <br /> �vork lor which applicnfion is mado and 1 compty with the Sfate Contrucfors Laiv 18.27 RCl4�and <br /> 296.200 WAC. <br /> ��� � - [� 'i � i < <br /> ���ture—_._: Date ��i'-i� — � �J <br />