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�LECTRICAL 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 /> �� � / C' C � �� . <br /> � <br /> PROJECT ADDRESS <br /> �_ � l . -� �� . <br /> OWner MailAddress Ciry Slale2ip Phone <br /> Tenanl MaitAddress City Stale2ip Phone <br /> � `,� .- � S L�( t ( 7-3� �Jn �F 'V4/ ��y �6<,Y�=+O %��%� <br /> Electricai Coniracbr Mail Address City State2ip Phone <br /> � 1-� � �rn�.s� ,�.� .._--_ <br /> 5 +' <br /> Slate Licenso Number Contr2cl Price of Work <br /> �� S �� <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Oescnpliono(WorkloBeDone: �%� a ��v� ��✓!l ��J�� <br /> -� � <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhal l have read and examined fhis application and knoro fhe same to Ge We and � O�1 U l �C�\3 <br /> correc�,q�1 provisions ollaws anA oidinances�ovemmg this type ol work will be complefed <br /> whefher s��ecilied herein or noL The gmnfing o/a pemut does not resume to give aufhonty fo <br /> vio{o(e or cancel fhe provisions o/any other s(ate or local law�eguPtin�consfrucfion or the <br /> petlounancebl constn�ction. Thaf 1 am aut ronzed by fhe owner ol this property to pedonn Uie <br /> w rk lor�rhich applicafion is nnde ar 1 c niply wifh the Sfafe Contracfors Law 18.27 RCW and <br /> 2 d6200 WAG. // A�� <br /> /� / <br /> � - � /.� -.���� 7 <br /> ignaWre Date <br />