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ELECTRICAL PERMIT APF�LICATION <br /> CITY OF EVERETT PERMIT SER`VICES <br /> 3200 CEDAR STREET, EVERETT, WA 982US <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org /� `"�3 —�� � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C �6�� �� � S <br /> �J OU l,�% � <br /> PROJECT ADDRESS <br /> (TL10��� �/�f�l� SC'i"i <br /> Owner M11ail Address Cily Slale2ip Phone <br /> lfLlO�f� S('�"i�� <br /> Tenanl Mail Address City Statc2ip Phone <br /> f�,�r�i�r �J/v l�i�tiii 1 �ic� /vPlr,�rl ;� /2<� Gk s�f �i�o <br /> Electr cal Contrac�o� Mail Address Cily StalelZip Phone <br /> Stato License Number Contract Price ot Work <br /> Proposed Use ol Building Contact Person (Plan Review) <br /> Description ot Work l0 6e Done: � '�il�� LL)� l�(��7�✓5� <br /> t <br /> NOTE: W�RING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CAE3LE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf 1 have read and exami�ied this application and know fhe same to be frue and <br /> conecL All provisions ollatvs and ordinances goveming fhis fype ol work will be completed <br /> �vhether speafied herein or noL The granting o/a penmf does not presume to give aufhonty fo <br /> violafe or cancel fhe provisions ol any ofher sfafe or local law regulafing consWction or the <br /> perfonnance ot constructwn. Thaf 1 am authonzed by the owner ol flns property to pe�fomi Ihe <br /> �ro�k lor�shicli application is rnade and I comply with fhe State Confracrors Law 78.27 RCW and <br /> 296.200 INAC. <br /> / <br /> Signalurc Dale + ���'�� <br /> (��// <br />