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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 �j— .= O -U•7 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C.=J ��`I `� S 7 <br /> ���� I (nt, (CE� S �'4�l C�_ <br /> PROJECT ADDRESS <br /> 7e6 7? � <br /> ��e-S� �� o Sd n 1 �o c�'i 1 Cra �-� � Z�(� <br /> /�/� l=✓�?;e (-4 `i$ � o I <br /> Owner A1ail Addross Gty State2ip Phone <br /> N f�'� <br /> Tenant A7ail Addross City State2ip Phonc <br /> FI`,,-� � ..�./ <br /> Electrical Conlraclor Mall Address City StatelZip Phone <br /> �t S C <br /> Slate License Number Conlracl Price o(WorY, <br /> �s,� l-bpsen <br /> Proposed Use of Building Conlacl Person (Plan Revie�v) <br /> Descnplion of Work to 6o Donc: �[� i•-�(!��' /( C �<<<CC: 5 < <�cq �.c I�-��i i0 r �;.;{ (� {- <br /> \y c:�ri'� a� IC\�1� 1.�, e 1C'� l-J c. �� 1 U r.e t,� f.Z SC E . CJ�i�� <br /> NOTE: WIRING I�d NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I heraby certily ihat 1 have rend ond examined this applicafion nnd know the same to be true ond <br /> correcL All provisions ollaws and ordinances govemmg fhis f}�pe olwork will be complefed <br /> �vhether specified herein or not The granlinc�of a pemid does nof �resume fo give authonty to <br /> vielafe or cancel the Provisions of eny other st�te or lecal law re�ulafing construction or the <br /> perfomiance o/cons�nufion. Th��t 1 am nufhorized b}�the oirner oI th�s property fo perlonn the <br /> �rork tor�vhich applir,afion is made and 1 comply reith the Sfafe Contrnclors Law 18.27 RC61�and <br /> 296.200 4l�AC. <br /> /�� � C � CG�/ <br /> SiqnalLre� Date <br /> . � - — j <br />