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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 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��C�C' S�, �/A�� I�f v2'i! cLLI/�'I. �Cci <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Mali Addross <br />Mail Addrass <br />City <br />City <br />Stale2ip <br />State/Dp <br />3 -i7 � l� <br />C l/03-<7�./0 <br />Phone <br />Phone <br />i ���Hs,��i�c7-i2�c,.ly'0�3-f12tAn,c�5[u�y.NSNor�����9yr�s ao6s`v.z_S�r <br />Elec�rical Conlraclor Mail Address City State2ip Phone <br />i'r'cl_� 3 r: /0 2. <br />Stale License Number <br />n����- <br />Proposed Use of Bu(Iding <br />Descriplion of Work lo Do Dono: �- ( K(= L) H �"t /� G I� "�' ��/-} ((� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED 70 <br />RE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />T a,�f'_M , <br />Conlract Price of Work <br />Confacl Person (Plan Review) <br />I heroby ccrti(y tlref 1 have read nnd exernined this appliceti�n and knav fhe s�me to be frue and <br />correcL All provisions olla�rs and ordinances govemmg this t} pe o( work will 6e completed <br />�rhefher speci�ed herein or noL The grantin� of a pennd does nof presume to give authonty to <br />i-iolafe orcancel the provisions of an}� othersfafe orlocallaw regult�ting consfruction orlhe <br />perlormance o/ constn�cfion. That I orn nuthorized b}� the o�rner of fhrs property to peAorm fhe <br />�vork Inr �vhich application is m^do ond 1 cornpl}� u�ifh tlie Sfate Confractors Law 18.27 RCW and <br />296.2GJ Ih�AC. <br />� <br />7�:�CC j/J�f .�r .J�_-L"��L:-e7 - <br />FEE <br />(� � I U3'- lJ C= �� <br />