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ELECTRICAL PERMIT APPLICAT60N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org / — ��— �9 <br /> �o � o/�D3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> , o l �. CD,n�u.'.o�-.�:^.� �i..� . _ <br /> PROJECT ADDRESS <br /> ����VVID�I i — <br /> Owner A4ail Address City Slate2ip Phonc <br /> Tenant Mail Address Cily S�atelZip Phone <br /> �C�a <br /> AIU� ��e��t,�c.. l� z� P,,Lk�+� ��i Sv�ol�ou..��� L�c�`iQ>z�;a �r��=z�3 <br /> Eleclrical ConUaclor h7ail Atldress City Slate2ip Phone <br /> �������� �:�� l� ���� ��z�� - <br /> Stale License Number Conhacl Price of Work <br /> `�� �k <br /> Proposed se o(Building Contacl Person (Plan Revie�v) <br /> > > �e �e�� v�2 v � � � �.�l.e_ <br /> Description o(Work to Be Done: �'��`\ <br /> Vl1�l�� <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 ��� ��— U�� <br /> 1 hereby certily fhaf 1 have read and examined fhis application and kno�v Ihe same fo be Vue and (/ <br /> conect All provis�ons o/laws and ordinances governmg Ihis type of�vork�vill be complefed <br /> �vhether specdied herein or noL The granfing o/a pernut does not presurne to give authorrty to <br /> ' violafe or canc�1 fhe provisions o(any other sfate or local law regulafing consVucfion or Ihe <br /> i perlonnance oTconstruction. That 1 am authorized by fhe owner ol this property to perform fhe <br /> �t�ork/or which pplic�lior mde and I comp wil the Sfate Contrac(ors La�v 18.27 RCW and <br /> 29620 AC. <br /> � � <br /> �- _ � \ 1 �7� Zk�i _ <br /> Sic�natu e Date <br />