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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 />_'' � 1 1� ��� n,� ✓' f-� L^-1 <br />PROJECT ADDRESS <br />�'- 9 0 � <br />��°��� <br />�c�� lv�; ��S ��m� c.� A-� n� <br />Owner Mail Address City Slale/Zip Phone <br />C — <br />Mall Address <br />Mail Addiess <br />� �' � .� <br />�r� v��e L�l'��!'� C� <br />State License Number <br />,� <br />a-�z�,�l��,.l ,� I <br />Proposed Use o 8uildin� <br />Descriplion o( Work (o Dc Dono: <br />i7 - . � ,.i .� /_� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN R,4CEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Ciry <br />Slate2ip <br />Slale/Zip <br />Phone <br />Phone <br />SOnO - r"��; nn t=��l; ,n�. -�e <br />Contract Prico of Work <br />���S�l (�i�if� <br />Conlacl Person (Plan Review) <br />1 hereGy certily fhat 1 havo rend nnd exnmined fhis application ond know fhe sarne to bo t�ue and <br />correcL All provisions ollaivs and ordinances govem�ng Utis fype of �rork will be cornploted <br />whe(her speufied herein or not The c�ranling o! a pernuf dues nof presume ro give aufhonty to <br />violafe or cancel lho rovisions of any o0�er sfafe or loc:il l��r reguleting consWcfion or fhe <br />perforrnance o/ cons{�nichan. Thnt I am autho�ized b}� fhe o�rner o/ this property fo peAnmi the <br />�rork lor �rhich application is m��do and 1 comply �vi(h tlre State Conf�actors L�+w 18.27 RCIN end <br />29�.2001NAC. ' <br />� � i <br />i ` � � <br />i� �% \� � �_ �1 - Ol`J <br />FEE <br />��! _ /� � <br />� <br />