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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES ��_(�,rp� <br /> 3200 CEDAR STREET, EVERETf, WA 98201 � I' `�a� <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org Q� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I �- Z l - �G�C���^-��DC.. I 11 �� - <br /> PROJECT ADDRESS <br /> �t?<1� ; �� ��� l E�Z� ���lei�u2. ����� ��na�- <br /> Owner Mail Address City State/Zip Phone <br /> Tenant A1ail Address � �y Stale/Zip Phone <br /> �4 \/� C.t�2L�2L � �11.�� /� � �1 � �Ylb. WC�� q�i2- 1l7 JE,dSC��ZU 33- <br /> EICCiricai ConlraClof Mail Addmss Cily Slatc/Zip Phone <br /> l���ZCL�1'b�XJ �_ (c6 UO � <br /> Sla�o License Number Conlracl Price of Work <br /> J . � . (� � STiVE - ZOh�-� lla6 <br /> Proposed Use of Buildinc� Contact Person (Plan Review) <br /> Descriplion oI Work to De Danc: /�'\ (U�� ' ` 1' -��-` �� f�'"�" `' � <br /> ��y�,�- ���- <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> B[ IN RACEWAYS, MC OR AC CA[3L[. <br /> CITY OF EVERETT LOCA�SALES TAX CODE IS 3105 <br /> 1 hereby certily fhat 1 have reaA and ex<vnined this application��nd kno�v the same(o be tiue�nd <br /> conecL All provisions o(laws and ordinnnces govenung this type of work n�ill bo complofed <br /> �rhefher speci(e hercin or noL The�ranting of a penn�does not/�resume fo c�ive authonty to <br /> violafe or cance he proaisions ol any other stato or 1 ca Aaiv regu ating construcfion or the <br /> perfomiance ol ons�niction. That 1 a u authorize �fh o�tiner o/fnis properiy fo pedomi fhe <br /> �vorh lor�vhich plicetidn isnta . nd 1 compl}� rith th Slate Con:racfors La�r 18.27 RCW and <br /> 296.�11Ar. � , <br /> � <br /> ��_�l-�� � ' -- - � �—y �Z��j� _ <br /> � J <br /> Signalur , � � Date �t/� �� <br /> � <br />