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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERM17 SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPT[D FROM 8 AM TO 4 PM <br /> / -� .Z :� /-! L Y ( �J l:�l- <br /> PROJECT ADDRESS <br /> /.' ��.i'� ND t� �= 11F- 1= � � r. :i i�i�:j I� i���= ��=�� 'l �=C,� y�� z'�`2-•lY `�-� <br /> Ownnr fdail Address City Slate.2ip Phone <br /> Tenenl F.18i1 ACdrbss Ctl� State;Zip PhGre <br /> ,l{ � �, �Nry Lc,_� ,—�I L c� u r�.l l <br /> Electrical Contractor Mail Address Crty Statcilip Phone <br /> ��( CL- i�' �'—� Cc• ;� fJJ _ <br /> Slale License Number Conlrecl Price o(Work <br /> ; F'J� <br /> Proposed Use of Building Contacl Person (Plan Revi�:•�) <br /> Descriplion of Work lo De Donu: l.V � I��-- I�J i_ �-_ i�> Di� I 1 1 V 1�11 � �- I l �H Ic-��> <br /> hLL;:: Li�T.L �KSiSI iNL, �cc, i� �+ni� S'���.�i<�-=- <br /> NOT[: WIRING IN NON-DW�L�INGS IS REQUIRED TO FEE <br /> [3E IN RACFWAYS, MC OR AC CABLE. <br /> ��j �_� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify fhat!have read nnd examined this application and know fhe same to 6e true and � �,'7 Ch- t� �� <br /> correcL Al/provisions ol laws and ordinances goveming Nus type o/wo.�c will be completed <br /> �t�hefher sper�/ied herein or nof. The granfinq nf�pennit does no!presume to give aufhonty to <br /> violafe or cancel fhe provisions ol any o0�er,.tafe or local law regu/ating construchon or the <br /> perlom�ance o/cnnsirucfion. fhat 1 am eufhorized by fhe o�vner o(Ihis pruperty(o per/onn!he <br /> work/ �nHich�pplicafion is made and 1 compl}�with the State Cen6acfors La�v 18.27 RCIN and <br /> 296.2U� bi�AC. <br /> � ,,-- ;/ - G � <br /> ; �Si�jn ture � _ � oate <br /> '��� <br /> i <br /> , � <br />