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ELECTRICAL PERMiT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8 i10 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � <br /> ) /� i% <br /> ..%1 �� %/,%i�1`I '1' �� �/Ctij3—Llr <br /> _ , <br /> PROJECT ADDRESS <br /> ���/l r / ) �. <br /> �`�Gf:(,{J�`V (/Vl��I�G) SiL�'PSS �J�`��'�� -�v� ��;/� ✓ ���iGS � l 1 "'� �� � <br /> Owner Mail Address Ciry Stale2ip Phone <br /> Tenanl Mail Address Cily Stale2ip phone <br /> �� � .� <br /> ElecUical Contraclor Mail Address City State/7ip Phone <br /> Slale License Numher Contract Price of Work <br /> Proposed Use o(Building Contacl Person (Plan Review) <br /> Descnption of V'ork to Oe Done: ��h C� YI'l 1-7.�7 /����'V�v� ,J!��V�/G�� <br /> u <br /> NOTE: WIRING IPJ NON-DWELLINGS IS REQUI�EG TO FEE <br /> 66 IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf 1 have read and ezamined fhis applica(ion and know the same to be We and <br /> correct. A/l provisions o//aws and ordinances poveming fhis fype ol a�ork will be complefed � �,tic l Z-U r)z- <br /> whether specified herein or not The c�ranting ol a pernut does nof presume fo give authonty fo <br /> viola(e or cancei the provisions ol any other state or local law rec�ulating consfruction or fhe <br /> perfonnance o!consfruction. That I am aufhonzed by the owner o/fhrs propedy to peAorm fhe <br /> work lor which application is made and/comply�vith fhe State Confractors Law 18.27 RC W and <br /> 296.200 lA!AC. <br /> i <br /> � ��c. ' �.u/`— �.� " /j— � � <br /> Signature Daie <br />