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ELECTRICAL PERMIT APPLICATlON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8657 —www.everettwa.ory <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��- �) � � "�'7 �U� <br /> PROJECT ADDRESS <br /> �I-�J ����� �lzzr _ ������,N� ms �� �v�- �r� z � <br /> wner Mail Address City Slale2ip Phone <br /> �/� -��� �/� ( <br /> l'erant Mail Address Cily Slate2ip Phonc <br /> [ICCIriCal COnlfaClOf M1tail Address City Sfate/Zip Phone <br /> Slate License Number Contract Price of Work <br /> /�- L�l � ���` ����'�C � - Conlact Person (Plan Review) <br /> Proposed Use of Building <br /> � - Z�- /�-- Lc� �'7���C1/�L/TJ� C. <br /> Descriplion of Work lo Bo Dono: � � <br /> NOTE: WIRING IN tION-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACE\VAYS, MC OR AC CABLE. <br /> I CITY OF EVERETT LOCAI SALES TAX CODE IS 3105 <br /> 1 hem6y cerlify ihaf 1 have reed and examined Ihis application end know the same to be fruo and � l l�C� -- (� ` <br /> comect. All provisions of laws and ordinances governing Ih�s fype o(�rork will bo cornplefed <br /> �vhether speafied herein or noL The granfing o(a permd does nof rosume fo give authonty fo <br /> violafeorcancelthe provisi�nsolanyotherstateorlocallawre��Pfingconsfructionorthe <br /> pedormar.ce of construction. That 1 am authonzed,by the owner ol this propeAy to peAomt fhe <br /> work lor�vhich application is made nnd 1 compty wdh tho State Contractors La�v 18.27 RCW'and <br /> 29G.200 lh'AC. <br /> � � , <br /> � / � � �' -Z6 - 2-�/� <br /> , ;4-�! <br /> ignaWr Date <br /> � <br />