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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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> { � C7 U �t�Ci�Z �lF� <br /> � <br /> PROJECT ADDRESS f.�Z; <br /> : .� � ���:�.� �l� �� � aa aY <br /> , <br /> Owne� Mail Addmss City Slate2ip Phone <br /> Tenanl Mail Address City State/Zip Phone <br /> �x�� ����- r-���<<s i s�3� qa�� S� 5� ,���-� �� �.� yzs$3,3� <br /> Electrical Contratlor Mail Address Cily State2ip Phone <br /> I �sk<<�qssQa �,�b <br /> State License Number Contract Price o(Work <br /> Proposed Use of Building Contact Person (Fian Review) <br /> Description of Work lo Be Done: �.�C� ��� rv+�"q� cCh'�"`'�- �v� "`-Q <br /> �s Nel - <br /> NOTE: WIRING IN RON-DWELLINGS IS REQUIRED TO FEE <br /> B[ IN RACFWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereUy certily thaf I have read and examined fhis application and know fhe same fo be true and <br /> con�ecL All provisions o!laws and ordinances govemrng this(ype o!work will be complefed <br /> whelher speci6ed herein or noL The gr.:nting ol a permtl does nof presurne to give authonty to <br /> violafe or cancel fhe provisions o(any ofher sfate or local law regu/afing construcfion or fhe <br /> perlormance o(consfruc6on. 7' at 1 am autherized by fhe oHaier o(this property to perform fhe <br /> work(or which ap icafion is m . and 1 comply wilh fhe Sta!e Cont�actors Law 18.27 RCW and <br /> 296.200 WAC. % � <br /> /' ;�� ��Z�v�-_ <br /> SignaWre Date <br /> ��1a�t-��`f <br /> I <br />