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ELECTRICAL PERMIT APPLIC.ATION <br /> CITY OF EVERETT PERMIT 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 /> T��`1 !/����'J/�.�� ��1C7 <br /> PROJECT ADDRESS <br /> �'�lA��������iv 7?z�l dL-�ll�/'�C /�i�'�'7lG��E�I� J�/19� 9�1D3 �3� <br /> Owner Mail Address City Slale2ip Phone <br /> Tenanl A1ail Address City State/Zip Phone <br /> /�r^2��CJ/JL�' __ �125-3�l3�?S"� <br /> EleclricalConlrac�or h1allAddress City Slale/Zip Phone <br /> Stalo License Number Conlracl Price of Work <br /> Proposed Use of Buildiny Contact Person (Plan Review) <br /> Description o(W ork to�e Done: � ��� � � � ������J_��'r�(� .� N <br /> l�Z.,� ����t'� l�L� <br /> � NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> B[ IN RACEWAYS, MC OR AC CADLE. <br /> � <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I Aereby certily Ihat I have road and examined U�is application and know fhe same to be truo and <br /> correct. All provisions ol la�rs and ordinances govem!ng this type o(work will be completed <br /> �rhefher speci6ed herein or noL The c�ran(ing ol a pemid does nof presurno to give aidhonty to � r^ <br /> violnte or cancel the provisions olany ofher state orlocallan�regu/ating wnstrucfion or fhe � � ��� <br /> perfonnmice o/construcfion. lhnf I am airthonzed b}�the o�cner o/fhis prope�fy to perlorm fhe � <br /> �ro�k lor�rhich application is made and/cornply u�ith the State Confractors Larv 1827 RCW and I I <br /> 2sc.zoo wnc. � � <br /> J p,� 7- ��- l <br /> ic� aty , ' ' - Date <br /> / <br /> t�' <br />