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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � Z `.� � 7 <br /> 3200 CEDAR STREET, EVER[TT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everetlwa.org C b 71 Z.-o o Y <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /�C�S ��l�t'S �l/e ��i.�S"c' �` w c�,e�fS/�D� <br /> PROJECT ADDRESS <br /> J�c1l � C'Ro���� / ��; �- �f�'��'��i� c�/����7T c�,�- ��a I <br /> _��y�jJ hlail Address Cily Slate/ p Phone <br /> Tenant Mail Address City State2�r � Phone <br /> Sr2 t ( �t��� C��rJ�� � �����a.�� ,.S��i`,-��� <br /> Elecirical CoMraclor �dail Address City State!Zip Phone <br /> � <br /> Stale License Number Conlract Price of Work <br /> 7C/LSt• ` J h�/� C�-tJ��LS1� <br /> Proposed Use of 8uilding Contact Person (Plan Review) <br /> ; ) �./; <br /> ��� ' �'�� ,T� /1-�� /2 �� .J�' �/n/ d . <br /> Descriplion of ork t B ne: � � <br /> Gf� r�� v c� /�' ' <br /> - . �,�.-��— _- �o��l� /� <br />-. --- _- �Ie��= � U�'• P�J�ti�.Z . <br /> _= <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 horeby ce�tily fhaf 1 have read and exarnined this applicatia�and kno�v fhe same to be Vue and l= L l � �- -���a <br /> corre�L All provisions ollaws and ordinances govemmg fhis type ol�sork n�ill be completed <br /> whether speci6ed herein or not The granfing ol a permd does not resume fo give authonty fo <br /> violate or cancel fhe provisions ol any other state or local law reguPfing construction or the <br /> performance o/construchon. That 1 am autho�ized by the o�vner o/this property to perform the <br /> work(or�vhich applica6on is made and 1 comply wilh fhe Sfale Contracfors Law 1827 RCW and <br /> 296.200 WAC. <br /> � � <br /> ��I1 . ����� ��2��=�-�'��I ��� G � <br /> l`�;'�Sigr�ature Da�c <br />