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ELECTRICAL PERMIT APPLICATICIN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM o _ a b � Q 6 <br /> I )a) =� St f�•�e+� t^?k(� �J�r� �' ��"e � <br /> PROJECT A�DRESS <br /> ;�, �>.e �-) j�l� ( f GG` <br /> ONrtle� MailA::dress City State/Zip Phone <br /> /�+1�/ t �t�l,,,✓E �cL�� +�.:.y D,(l,�e �ze5 SE �;,�:.et/ /yJ.✓/a%M �a//� !✓� <br /> TenBnt Mail Atldr ss Ciry State/Zip Phone <br /> �ijl�,Sl�� f�C��C�� �%`'Sf .7�Y• �S �vS�J��:z/j� L.r.a �j',���/U �O� .�Zy1/��`�� <br /> ElecfriCal COnl�BCtOf Maii Addmss City State2ip Phone <br /> /Jv �2�r�-IS� �3��� ``" i 2, Yc.� <br /> Slate Lfcense Number Contrad Price of Work <br /> U��t ��� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> DescriptionofWorkroBe�one: /t'�/�"'/ �.�� ''�'rl��" �X/Sf"����e ��•`^c.�e � ''�-"��' �Z"`'�r""�� <br /> SW � ��� � �Q��Oi�ft / )�/� C�l�✓P�9/}�/Y �"li1 �a'-' �C i��c� 9�1.��/avl C/^C�:� <br /> NOTE: VNRING IN �ON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �(� � -� <br /> �X�;, <br /> v <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 liere6y certily tliat 1 have read and examined this application anC know the same to be true and <br /> correcf. A/l provisions ollaws and ordinances govemmg this type ol work will be compleled <br /> whe(her speafied herein or noL The granting of a permd does notp resume ro give authonty ro <br /> violate or cancel the provisions o(any other state or local law regulating constru;;fion or the <br /> peAormance ol conshuchon. �hat I am authonzed by the owner of this propeRy to peAorm the <br /> work lor which application is made and 1 comply wrth the State Contractors Law 18.27 RCW and <br /> 296200 WAC. <br /> � � I <br /> ` � /l�- �J - ZF ��l <br /> , � ��(j�-� � �� <br /> Si�7naWre oate ;� ._ � <br /> �'" �-�// / <br /> , � <br /> ��. <br />