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ELECTRICAL 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 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � � �I I �>> � ���-� �� �ve1� f-1 ���'� `���S �3,�� <br /> PROJECT ADDRESS <br /> ���� - <br /> ;��`I ' �c�S '.:� <br /> �� < <; `,_�\c ��� f `�`11? f i� � - �v�� � r t1 �., `� �3 <br /> < .� � , ,� � � r� /8_a , <br /> Owner `� Mail Addrnss Clly Slale/Zip Phone <br /> � <br /> 1 liA - .�C������4 _ :,.:� �1•,,°v-'�. <br /> Tenant Mai�Addross City State/�ip Phona <br /> � � „��l' .� <br /> Elec�riCal Conlraclor Mail Address City Slale2fp Phone <br /> Stale License Number Contracl Price of Work <br /> Proposed Uso of Building Conlacl Person (Pian Roview) <br /> Description of Work lo Bo Dono: �II ��L. i. r�r� \�� � � � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R,4CEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceriily that 1 have read and exnmined this application and kno�v the samo fo 6o fruo and ( l , (�('Cf-- (�� <br /> contct. All provisions of la�rs and ordinmtces govemin�this type o(work will bo compfefed � <br /> whether specified herein or noL The�ranting of a pennd does not rasumo fo givo aulhonty to <br /> violato or cancel the provisions of any ofher sfafe or local la�v reguPting consWction or the <br /> perfomiance oI consfruction. That 1 am authonzed by the o�rner of fhis propeAy fo perfonn tho <br /> worklor ivliicli application ls mado and 1 comply�vith tho Stafe Con6acfors La�v 18.27 RCW and <br /> 29G.200 WAC. <br /> I � ' ,, �� l �� I I( <br /> � \`:�1.�`l ��`i� �\ <br /> Sic�nature Date <br />