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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 /> /,� 1 / <br /> �8-r P/}c � Fi[ �✓F <br /> PROJECT ADDitESS <br /> yZS 4�F—I09S <br /> ,�i K 777EG �,toOG,+! T/f5 /000`/ �,�aRA �✓� 5£�4rrzF. !.�/A. ��/3_� <br /> Owner Mail Addross Gty State/Zfp Phone <br /> ��Q,� �OMHd.�,�tiT/t /7M� <br /> Tenant Mail Address City Slate2ip Phone <br /> ZvL <br /> J�.�• ►�DY E�sr l� o i:rr �vr L rN.��✓oa G�/�. G,�or6 ysi-�,e <br /> Elecirical Contractor Mail Address City Slate2lp Phone <br /> T3 cF_ D,4o i 9 3 Z G� �//0 d <br /> State License Number Conlract Price o(Work <br /> �X � 5 i in/L /�07 ,(��ln �/Lti�F /�Vn� f �N <br /> Proposed Use oi Building Contact Person (Plan Review) <br /> �escriplion of V�'o�t ta Do Done: _���L�'C'F �/9r✓EG <br /> NOTE: WIRING IN NON-DWELLINGS IS �FQUIRED TO �E <br /> DE IN RACEWAYS, I,�C OR AC CA�LE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf I have read and examined this application and know 1he same fo be We and <br /> correcL All provisions of laws and oiCinances go��emmg this type o!work will be completed <br /> whefher sp� 'd�ed herein or noL The pranling ol a pernut does nof presume fo glve author�ty fo <br /> vio�afe or cancel the provisions ol any other sfato or local law regulsting construction or fbe <br /> pe�fonnance� `consiruction. Thaf 1 am aufhorized 6y tne owner o!this property fo peAoim fhe <br /> u�ork lor whicl application is made and I com�;ty wifh the Sfate Con6acfors Law 18.27 RCW ard <br /> 29G.200lNAC. ' ' \ LI <br /> �J <br /> �.�.�.._._�� � �1�,C 7 - Z 3-07 - �(��� <br /> �- Signature Date <br />