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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAP. 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 /> ��t �(� C Fi KY�J /'�I�G • ���L��C f'�7" �L L L� � <br /> PROJECT ADDRESS <br /> i <br /> �n,�,r�.- CE"�� 75�)-; ���l�E� ��� < <<� y✓�� �,� . 782c, � �/Z�-1�-�0,9�, <br /> Owner Mail Address City SWle/Zip Phone <br /> / <br /> TBnant h4ail Address Ciry Stale/Zip Fhone <br /> ,C.�cz,-v�.,� f`�-��-�v� C 5'-GJS /84'� .5� sE 5lv>!v))o,�r<.([ �c�a,• 98L9� <br /> ElectricalConlracto / � sf`����Address Ciry State/Zip /'�_,ZS-1 (�Ph�� , <br /> l / �'f ( n <br /> ��i:(t (nJ�^/�GTll�'�T <br /> State License Number Contracl Price of Work <br /> Proposed Use o(Building Conlacl Person (Plan Review) <br /> Descriplion of Work lo Be Done: S PVV C L' �la %'��^�� <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. __�.r, <br /> � f, <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 he�eby certily that 1 have read and exarnined this applicalion and kno�v fhe same fo be true and <br /> coRecL All provisions olla�vs and erdinances�overninp fhis type o/work will be completed <br /> whether specilied herein or noL The�ranting ol a pennrt does nof resume fo give authority fo <br /> violafe or cancel the�rovisions ol any other stafe or lor.al law reguPting construc6on or the <br /> performance o/consfruclion. That 1 am authonzed by the owner o/fhis property fo perform the <br /> work/or�vhich application is made and I comply�vifh fhe Stafe Contracfors Law 1827 RClNand <br /> 296.2001h;4� � <br /> �Signature / // Date j <br /> O/JI' j,� <br /> �I <br />