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ELECTRICAL PERMIT APPLICATfON <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 /> � ,�iCil, I��UV��J1�1 C��/��' • ��r�GG'% <br /> PROJECT ADDRESS <br /> �2�'G���zu �/Il r,l�zar� %,,��-,.� <br /> Owne� , Mail Address Cily State/Zip phone <br /> Tenanl btail Address Ciry Stale/Zip Phone <br /> ��i-'/c��� r%�7 vi? �?v. l'�o�-� /�'IH �' �i��v/������Li 1,�2 � 4 57`�� <br /> EleClrical ContraclOr Wail Address Cily Statc2ip Phonc <br /> ,��;�'�/��F� �`1�15�1/k' -7�;�u �,s <br /> State License Number Contract Price of Work <br /> i <br /> n � <br /> ;[Y,%S��'(uz(ny ll'� <br /> Proposed Use of Building Contact Porson (Plan Review) <br /> Description o(Work to Be Dane: k-P_V(/i/.;1, �t/r /.�/3y7 c�' 'j J; �L . �-����j r�<i `�� <br /> , - � r, <br /> � , �14�(,'�� ! �, r'(�1 ''� <br /> NOTE: 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 /> I he�eby certily that I have read and examined fhis applicafion and know the same to be Irue and <br /> conecL All provisions ol/aws and ordinances goveu�ing lhis type o(work n�ill be completed <br /> whefher speci6ed Iterein or noL The granfinc�o(a pernut does not resume to give authonry to <br /> violate or cancel the provisions of any other state erlocal lmv reguPfing consf�uc6on or fhe <br /> perforrnance ol constructiai. That I am authorized by the o�vner o/fhis property to perform fhe <br /> work lor which application is made and 1 compty�vifh the Slate Contractors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> �� � j . <br /> _ �' /i -� ��-�r � 0 `�/"). (�1,� '1 <br /> Signature pa�e � � rL�l <br />