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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 425-257-8657—vrww.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �,�O� � �5 ��� <br /> PROJECTA�DRESS <br /> ��ne�-�ut �, �rn�� �vw�ro�'c�r� <br /> Owner <br /> MailAddress Ciry Slateldp Phone <br /> Tenanl ) <br /> MailAddress City State/Zip Phone <br /> ��,,,�� ���p , 7,3� ��D�f - ��(/. S�nwa� �!� �Z — <br /> Mail Address Ciry talelZin ��/ Phone <br /> Eleclrical Contractor `3� 3aOZ7�3� <br /> na <br /> �����,� � r D 3 > ,� 1 y�. � <br /> Slale Licease Number Conlract Price of Work <br /> Propo� Use�of Building Contact Person (Plan Review) <br /> — Squ���enlial new construclwn,remodel or addihon) / <br /> l �D 1� /,�� 'i % ns 7'� 1� <br /> Descrip�ian of Work to Be Dane: ��L �� ,� � <br /> I nCL� v2�Q /7' SYff/i�G <br /> l - l3 � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ���� � <br /> \.J <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � I hereby cei�ily fhat I l�ave read and examined this applicalion and knc�•�the same la be tnre and <br /> correcL A/l provisions o(laws and ordinances govemmg fhis type of�•;ork�vill be completed <br /> �vhefhcrspec�fied herein ornof. Tlie granfing o(a pemut does not presume to givo authonty to <br /> violafe ancel(he prov�sions olany ofherstate or local lar�regulafiny const�ucfion orthe <br /> perf man of consWc(wn. That 1 am fhonzed 6y fhe on�neroRhis properiy to pedomt the <br /> ��i ,lc far�vhi h appl�tion is n ade an �ply�vi(h fhe Sfate Confrac(ors Lae�9827 RCW and <br /> 2 6.20G WA . �^/� <br /> C '� C //����j� <br /> SiqnaWre Date <br />