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ELECTRICAL PERMlT APPLIGATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR Sl�REET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />_�- t. a • • i I <br />PROJECT ADDRESS <br />7_�y-o'i <br />C� d�c ; -oE� 3 <br />�....In%,!�(. �.FI�Lv r. -✓� L.�-� �4�r��� i✓ l�>_..'�� <'� -I,. � r..- _ <br />Qwner Mail Address � City Slale/Zip Phone <br />Tenant Mail Address Cily Stale2ip Phone <br />����i�. �.t: l.�: N,��. ���.� �l I - -n�•.�_� �� V.. �� ✓ �_ 'i` �1.�. <br />Eleclrical Contraclor M❑il Address City StatelZip Phone <br />,- ! <br />S(ale License Number <br />Propo ;ed Use ul Buildin9 <br />!j6�) <br />Contracl Price of Work <br />Contacl Person (Plan Review) <br />I , . <br />Description o( Work l0 6e Dm�a I�1 nJ � �'��� �N�.-� �; j� i r:� �i.� r � <br />i <br />NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />0[ IN Rl:CEWAYS, MC OR AC GA�LE. <br />CITY OF [VERETT LOCAL SALES TAX COUE IS 3105 <br />1 hereby cu�ti(y thaf I have reaAand exarnined (his applic�ition und kriou� the same to be true and � -� �J C'7 -�� �— 3 <br />conecL All provisions ollaws and orz/inances �overnmg fhis t}�pe ol �vork will 6e completed <br />whether speci(ied herein or noL The g�antin� o/n pernut does nof aesume tu give aufhority fo <br />violafe or cancel the provisions ol any ofher s!afe or local la�v regulafing consfruction or the <br />perlomianr.e ol consln�cfion. Thaf 1 am aufhorizeAby th? o�sner o/Ihis property fo perform the <br />�vorh lor �vhich application is rnade and I comply wifh the Sfate Contractors Law 18.27 RCIN and <br />296.200 WAC. <br />� <br />�� � � i � <br />(� �J % <br />--� Slc�ntln��. �� <br />r <br />/�%i !.? ,. <br />