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ELECTRICAL PEaMIT APPLICATION <br />CITY OF EVERETT P'ERMIT SERVICES <br />3200 CEDAR 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 />���0 OL`(r2l��L r��Vr7 <br />PROJECT ADDRESS <br />Owncr <br />h1ai� Addmss <br />t_-/ z � – <br />-� �� �� � L-V�.�2 l�� / 3 7 <br />City Stale/Zip Pliene <br />� <br />S A �ti�� - <br />Tenanl A1ail Address Cily Stalc/Zip Phone <br />�o�//v /3� v�,2c Y c.N-.L <br />� F�v`S�-1'� �- l L C�12 � cA L S v c� LC S r=v �--<m- 9 B,zu� `-1 ? 5— <br />EleclriCal Conlradof Mail Addiess Cify Stalc2ip . Phone �� � 3— <br />��:� �, �_S � y�/ �`/ -� 7�i <br />I= C O .� �� 9 "" <br />Slate Lic�nse Num �er Contract Price of Work <br />_P—+ � alf'_ h-� I l.-'� L <br />Proposed Use af Building <br />�— i r' �.�1, �_ S C?'f�_/ <br />�_� N ) � <br />Contacl Person (Plan Review) <br />Descriplion of Work l0 6c Donu: �-�� N c L C!-('�-i�� �( O/ti' C`/� — O� . ���- / n.l !�� ry/� <br />I <br />�-. <br />NOT[: WIRING IN NON-DW[LLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABL[. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereb�� catily fhaf 1 have read and examined this ap��licntion and know fhe same fo be hue and <br />correcL All provisions o� la�vs and ordinances goveminy this q�pe ol work will be completed <br />whefher specilied herein or nol. The yranting ol a pemirt does nof uesume fo give authonty fo <br />violate or cancel the provisions o! any ofher sfafe or local la�r regulating consfruchon or the <br />perfennance o/ construcfion. Thal I am authoiized by fhe owner o/ Ihis property to peAo�m fhe <br />work !er �vhich application is rnade and I comply wifh the Sfale Contracfors Law 18.27 RCW and <br />29G.200 WAC. <br />FEE <br />EjpU�-1� <br />