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ELECTRICAL PERMIT APPLICATION <br /> CITY dF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 — wwv��.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I O IS (�c,M���� iq ,/� <br /> PROJECT ADDRESS <br /> J U�/� �G1(1 fi���_ <br /> Ownef �dail Address City Slate2ip Phone <br /> Tenant Mail Address City Stale/Zip Phone <br /> �— v! Fl�c�-�� «I I oyZS i �` Pt �� ���e ,J�levc�� wA yd2S�Y Cy s�z�5-a 6 v <br /> Electrical COnlfaClor hlail Address Cily State/Zip phone <br /> IN{-; ovF1' 95 Z-C�G 1GGG ' �� <br /> Slale License Number Contracl Pricc�of Work <br /> Proposed Use of Building Contact Person (Plan Re�iew� <br /> Descriplion o(Work l0 6e Done: �('�JG (C' ZGG C�M J R'�✓��� <br /> NOTE: WIF�ING IN NON-DWELLINGS IS REQUIRED TO FEE � <br /> BE IN RACEWAYS, MC OR AC CABLE. I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that 1 have read and examined this application and knou�fhe same to ba true and <br /> correct All provisions ol la�vs and ordinances govemmg lhis fype oI n�ork will be completed E p�,� -G ��I <br /> whether speci(ied herein or noL The granting ol a pennd does nof�resume fo give au(honty fo � <br /> violate or cancel the provisions o/any othe�stafe or local la�v regu�ating constn�cfion or the <br /> per/onnance ol construclion. That 1 am authonzed by the owner o(this property to perlorni the <br /> �vork lor which applicafion is made and 1 comply wifh the State Confractors Lan� 18.27 RCW and <br /> 296.200 WAC. <br /> �- , ���/o� <br /> � Si�nature D te <br />