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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERViCES <br /> 3200 CEDAR STREET, EVERETi, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �L���,� � i s�( I��i , , � �� n•�.S <br /> PROJECT ADDRESS <br /> � <br /> �- <br /> 'I������� I_J��, A', �;, . � -t.I�'� ��� ��.�.. ,,�• {_,., tv: t�ta �� ����; ���—IL; � �� �Gr <br /> Owner � Atail Address City Stale/Zip Phone <br /> Ten,ml A1ail Address Gty Slale/Zip Phonc <br /> V��v�c\���n�CLI L��_i_�4� � C� L.t> _Li�c . L���ti� ��� - �I �,'c.t�- <br /> [leclrical Conlractor M1tail Address City Slale2ip Phone <br /> \�,`��.�.-1 L ti�_(� �/'�' ? N .l <br /> Slale License Number Contract Price of Work <br /> ProposeJ Use of BuiWing Contacl Person (Plan Review) <br /> � � 1 <br /> ` L � <br /> Descriplion o(Work lo Dc Done: ��%�-�'�v �_ V`�'`,�,�) C..�\.C�G�\ -{' G L��/ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAI'S, MC OR AC CABLE. <br /> �� <br /> � CITY OF EVERETT LOCAL SALES TAX COUE IS 3105 �I�' ( —�3� <br /> 1 he��by cerfilv lhaf 1 hace read miA ex<vnined this applicafion nnd know fhe sarne fo 6e Vue anA <br /> conecL All piovisions ollmrs and ordinances go��emmg thrs type ol�rork will be completed <br /> uhefher spealied he�ein or not. The granfinp ol a pernut Aoes nof resurne to gire authonty to <br /> violafe or cancel fhe pro��isions o/any ofher sfafe or local la�r reguPfing construcfion or fhe <br /> perfonnance ol construc(ion. That 1 arn authrnized by the o�rner o/Ihis property to perlomi tho <br /> �tio�k lor�vhich applic,ifion is made and 1 comply�rifh fhe Sfafe Conlractors Law 18.27 RC41�and <br /> 296.200 INAC. <br /> ,_ !������ � 1 �=� 1�a <br /> . <br /> u7nalure (' � Dale � <br />