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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 425-257-8857-www.everetlwa.org 1� -�3-�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM L�0 2"� -'i <br /> IOI Q {�OC7��C ��-e. <br /> PROJECT ADDRESS <br /> Owner Mail Address City Slate2ip Phone <br /> Te�� `�n� �I A�n e� ���{r City State2ip Phone <br /> SES �N� . P•►�B 2�1 ��.�urn C.�/, /9ao�z <br /> Eleclrical Conlractor Mail Address Clly Stale/Zip Phone <br /> �;t,�.> �r,��x�; �c; ,�rk �'y.so <br /> Slate License Number Conlract Prica oi Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work to 6o Done: �/�s���ry• El�e�r� e,l ` JMaoYI 2r!'}S //1�0 <br /> rv�od��l�ar �urn�-�-ure . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> B[ IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 /� <br /> I hereby certify Ihaf I have read and examined this application and know fhe same to be truo and Ci�� �Z -I 5� <br /> correcL All provisions ollaws and ordinances govo.nmg this lype ol work will bo completed <br /> wl�efher spealied herein or not The granfinp o/a permrt does nof �resume to give authonty to <br /> violafe or cancel fh� �roeisions of any other stafe or local law regulating consfruction or the <br /> performance o/cons�n�cfion. Thaf I em aufhonzed by fhe owner ollhis properfy fo peAorm 1he <br /> woik lor which application is ntadc�and 1 comply with the State Confracfors Law 18.27 RCW and <br /> 296.200 lNA C. <br /> _ �-�i��' !z/Z�/u <br /> Si�nature Uate <br />