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EI�ECT�ICAL PERMIT APPLICATION <br /> Cfl'Y OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 –www.everettwa.orc; <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� S —DS <br /> � � �� ,iC� C /� i%�l .i ��� - <br /> PROJECT ADDRESS <br /> / � � <br /> y,zs-3 s>-z�63 <br /> ��F /'7�,�� Ig i�� 27.�/�'Fr��PGJ �'��� �'vi��� C�lCj i-��O� <br /> Owner Mail Address City State2ip Phone <br /> Tenarl Mail Address City State'Zip Phone <br /> Eleclrical CoNractor f.l:iil Address City State/Zip Pho^.e <br /> Slate License Number Contracl Price of Work <br /> 1',�,�� <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> �� � /� , <br /> Description of Work to Be Done: � / � !��� � /� 9C"'l T� L. i i 7� 7 <br /> l7PE \ /"';;j�� _ <br /> i <br /> tJOTE: WIRING IN NON-DWELLINGS IS REC�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CFBLE. <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ccrtily thaf I have read and examined this application:mn know fhe same fo be frue and <br /> cor�ecL All provisions o!laws and ordinanr,es�overnmg fhis t��pe o/work�vill be cornpleted <br /> whefher specihed herein or noL The granting ol a permd does not resume tn give aufhonty fo <br /> vio/ate or cancel the provisions ol any other slafe or local law reguPting construclion or the <br /> perlorrnance ol consUucfion. That 1 am authorized by the oK�ner o/this property to peAorm the <br /> �vo�k(or which applicafion is rnade and 1 ��mply wifh fhe Sfafe Con6actors Law 18.27 RCW and <br /> 296.2001h'AC. � <br /> � � ,�% � � <br /> c3�� <br /> � � �/ �/� -- - --� ��/S �' �7� <br /> ' � �Signat re � Date <br /> ��S�D 'C7� <br />