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�1_ECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, 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 />r / ' <br />� C L� ,� C)-r-': r �,-/ ..�� <br />PROJECT ADDRESS <br />��tt..� //c��� �!'CiJ/,7e:�iil ���G�J �,-i-..n <br />Owner � Mail Address <br />Tenanl Mail Address <br />_„/.;,�,��,-- J�.,�rg /Si.��'.. *' /•v� J��'/ Ea <br />�lecirical Conlraclor Mail Address <br />�E� -��' � 5 ���Z � /� <br />�Slate License Number <br />�. <br />,c'�< <br />�1 l <br />Proposed I ��� of Building <br />Description o( Work to �c Dcac: <br />� � <br />i <br />� ����� �, ,�•., E-� �.,, <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN R,4CEWAYS, MC OR AG CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />✓ c �L . L � <br />Cily <br />Ciry <br />G �'r' %. - <br />Slate2ip` <br />State2ip <br />//�a j� LJZ <br />Phone <br />Phone <br />r;_ %J� < �-�C% ,'c. -�i'S"?�: / �i'z,; z ;%-<-' /F <br />Cily State/Zip Phone <br />^ � �o <br />/� �� L' <br />Conlract Price ot Work <br />Contacl Person (Plan Review) <br />1 hereb}� certily thaf 1 have read and exarnined this applicatiai and know the same fo be frue and <br />correct All pro��isions o( laws and ordinances goveming this fype of work will be complefed <br />�tihefher spec�(ied herein or noL The �ranfing ol a pennd does nof presume fo give aufhonry to <br />violafe or cancel Ute I�rovisions oI any ofher sfafe or local latv regulaling consWchon or the <br />performance ol constn�cliai. That 1 arn aufhonzed by fhe oivner oI fhis property to perlonn fhe <br />work Por �vhich app:rcation is made and I comply with the Sfate Contracfors La�v 18.27 RCL1' and <br />296.200 lh'A C. <br />—� C �� <br />i i <br />- � � i '� � <br />FEE <br />�o�ro r��� <br />/� <br />