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EL.ECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -wv�nv.everett��a.�rg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> y?z� ���-„�,.�;� ;�,� <��� r����n ,�z �3 <br /> PROJECT ADDRESS <br /> �I��CGic,�'�/f4j,'"��S C�D�.��.i,r�:C'r�./ �1L�4 EZi+�>(7 (�(/�/ It`jLU.� l/3Y�: CJS�`�� <br /> Ownef hlail Address Qly SlalelZip Phone <br /> Tenanl h9ail Address City SlaterZip Phenc <br /> �J� u7T�lrc��� .X�,c `/.i�/ Z� �i��/�,.r er/�C��„friz.�/ �.� �a'as`z y,S>c:SriS-� <br /> [lec rical Conlraclo� Mail Address Cily Slate�Zip Phone <br /> ��>�,�,TTc-� �f�t5�r'� � zC� , �c�u `°� <br /> Stale L cense Number Contract Price o Work <br /> / r C�c—s�� ��FS / /7C%'<�I-P <br /> Proposed Use of Building Contacl Person (Plan Revie�v) <br /> Description o(Work to Be Done: ��'�'C-u �t-s I r/��'� 7' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> ' BE IN RACEVVAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 J�2 <br /> I Nereby certily that 1 have read and examined this application,�nd know fhe same fo be true and �J� ' <br /> correct. All provisions ollau�s and ordinances gevem�ng fhis f}�pe o/roork�rill be compleled E <br /> whether speci/ied herein ornoL The grenting o/a pennd does nof resumo fo c�ive authonry to <br /> violafe or cancel U�e r�rovisions ol miy o(her stafe or local lau�rec�uPtin�consfrucfion or fhe <br /> perlormance o/construction. Thaf 1 am au0iorized by the owner o/fh�s property fo perform(he <br /> work lor which app/ication is maAe and 1 comply with the Stafe Confractors law 18.27 RCl1�and <br /> 296200 WAC. <br /> � � <br /> � / / . <br /> .�-'� _�-. � :���,.�� ` � � c <br /> — T_-'Sign�ltue Uale <br />