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, <br /> ELECTRI�AL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 5 _ 3 _ 11 <br /> 3200 CEDAR STREET, EVERETT, WA 962U1 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org !� // O S- O I � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �3� � 3 c��- s <br /> PROJECT ADDRESS L�Q11 y a S� <br /> �'�. . 1 �'U,��� ���� 1`��'` �� '(1�1U.k.���ea , 1r��-clg��i5 ��j-4aa� <br /> Ovr�er Mail Address Gry State/7Jp Phone <br /> Tenanl Mail Address City Stale/Zip Phone <br /> Electrical Conlractor Mail Address Cily Slate/Zip Phone <br /> Slalo I.icense Number CoNract Price of Work <br /> Pr000sed Use oi�uilding Contact Pe�son (Plan Review) <br /> �escription of Work lo�e Done: ����L ��rV`�`�� _- _ <br /> NOT[: WIRING IN NON-DWELLINGS I;i REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I he�cby certily Ihal 1 hare read and examined fhis application and know fhe same to bo tnie and <br /> correct. All provisions o!la�vs anA oidinances govemmg this typo ol�vork will bo completed <br /> n�hether speci6ed herein or nol. The granting of��pomul does nof resumo fo give aufhonty to <br /> viola(e or cancel the I�rovisions o/any ofher slafe or local law reguPting construcfion or fho <br /> perlormance ol consfnrcfion. Thaf 1 am authoiized by the owner o/fhis property to pedomi Ihc <br /> work/or which applicalion is mad�.grid I cornply with fhe Sfate Confracfors Law 18.27 RCW and <br /> zss.zoo yvn,c.� � 1 <br /> ���% �Q �i���' S�� � l� _ o r � <br /> Signature Date �/ 0� <br /> / <br />