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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-25?-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �D�� � ,�►�D A V� <br /> PROJECT ADDr�ESS <br /> G= H-R�S1cfJ5El�7 � �f�.5 ?-!`� /82Z <br /> ��1 T�Y 1-!n�a,GS/NG 2�3 n �i�G�<CfZ/kt� �(��K�T7- w/� `�(�i Z a( <br /> Owner � Mail Addr�ss City Slale/Zip Phone <br /> Tenanl Mail Address City Slatc2�p Phonc <br /> Eleclrical CoNraclor ldail Address Cily SWI��Zip Phone <br /> J�LiI;(.IG1;115� iVU1IluUl �v�i:r�c:^�cv Cf::'crl: <br /> ���ia� �D/JSTF'�r�7in,J <br /> Proposed Use ol Buiiding Contacl Person (Plan Review) <br /> Descriplion at Work lo Be Done: I�/�'(/�/' h' A FL-� Y��G��� L,� <br /> NOT[: WIRING iN NUN-DWELLINGS IS REQUIRED TO FEE <br /> 8E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 herebvi certily thaf 1 have read and examined this applicafion and know(he same fo be hne and <br /> conect All provisions o/lairs and ordinances govemuig Ihis f}�pe of work will be completed <br /> whefher spec�bed herein or nct The granting of a pemut does not resume to give aulhont}�to <br /> violafe or cancel the provisions olany other state or locallaw reguPfing consWchon or the <br /> performance o/construcGon. That 1 am authorized by tho o�vner�:l Ihis properly fo perfonn(He <br /> work lor which application is made and I cont�ly wifh the Sfafe Ccntracfors Lau� 18.27 RCW and <br /> 29G.200 WAC. <br /> � � <br /> .1�� �� � )� . . <br /> � ;-����r-,�- .r..� 7�/3�0� -� <br /> Sig ature Da1e /,_�� � <br /> � <br />