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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMlT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � :�o l �v��'z,'tt-� ��-v_� <br /> CUe��.e.,� Gv✓a- g Y �' o i <br /> PROJECT ADDRESS <br /> /7'1� �;��-�ti ���> 3�� - y.�y- ��. � <br /> Owner A7ail Address Cily State/Zip Phone <br /> j��f�, /,��,�-����s <br /> Tenanl Mail Address City Slale/Zip Phone <br /> �'�lv � �� s 3� Y L�, .�����>.�T %3i��.� � �iLj �/� .SC . .�9��a- '� y <br /> [lectrical ConUaclor Mail Address City Slate2ip Phone <br /> %�llr ? r"-�K L � �'/(o � 1' �� • �� <br /> Slale License Number Contract Price of Work <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> �escription o(Work lo De Donc: ( n� ✓� �� •S���'�'t.N 'S�S !`e v� <br /> Y ` - - <br /> Sl� C�r ���-G'S £ �.�r J'�� '�1 4 GGJ Q <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i <br /> CITY OF EVERETT'LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fl�af 1 have read and exemined(his application and knou�the sarne�o be true&nd <br /> �L�4 l 2 — �'�� <br /> correct All provisions olla�rs and ordin��nces_ao��oming tliis type o/�rork will be complated <br /> �vhefher specified herein or noL The granting o/a pernut does not resume fo give authonty to <br /> violafe or cancel fhe provisions ol any ofher state or local law reguPting consfruction or the <br /> perfomionce o/consirucfion. Thaf I am aufhonzed by the owner o/this�roperty to pedomi the <br /> ���ork!or which a�lplicntion is made and 1 comply tvith the Sfate Confmctors Law 18.27 RCW and <br /> zss.zoo wA„ _ ,��—� , ; <br /> , <br /> ///• /i - , / , <br /> �%GG� ' /��. Y�/c�.� <br /> �— SlgnaWre Pate ,� <br />