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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-d857 -www.everettwa.org <br /> PPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,;7 S / �{ T�� L J + ►J Q �1 C; <br /> PROJECT ADDRESS <br /> D �V�I� � i�,�D�,� k� ,;�14 F �/- ��� �UCF'�T ���, SRao� 3t.� - G3i-�IsO <br /> OWnur Mail Address City Slale2�p Phone <br /> L::7ant Mail Address � Cily State/Zip �hone <br /> 3 v�i o '-t � RVe_fJ�J y� <br /> S7'E ��cr-�i r� �:r�,�,:r�:� f'rn1�1��2 �T�'I't�;�lo �7> Ii-��I (��'l� :� b-fl�S'L�SS <br /> Eleclrical Conlractor Mail Adoress Cily Slate/Zip Phone <br /> C� <br /> t7Fr, iL��SIT� __ � (!0 <br /> S�ate License Number Contract Prico ot Work <br /> � � l� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion o(Wor6.�o�r. Done: �' � � lJ t ���l^� I �� �)� 1�i L�E�� L—+�1 I��i (F Q G-, <br /> 7— <br /> �u f� ( A C.� VY�o� r.�� c.�r- �7'N �Z �F oo F P "Yi � <br /> NOTE W�RING IN NON-0W ELLINGS IS REQtJIRED TO FEE <br /> D[ IN RAC6WAYS, MC OR AC CA�LE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerlily fhaf 1 have read and exarnined fhis application and know ihe same fo be(rue and <br /> corra�L All provisions ollaws and orAinances gorerning fhrs f}�pe ol work will be complefed <br /> whether speahed herein or noL Tne granting o/a pemut does no( n�esume to give aufhonty fo <br /> viola(e or cancel the provisions o(any o0ier state or local law reSulafing consfruc6on or tAe <br /> perfonnance o/construcfion. Thaf 1 am aufhonted by fhe owner ol this property fo pertomt the <br /> work lor which applicafion is made and 1 comply wifh the State Confracbrs Lcw 18.27 RCIh�and <br /> 296.20014'A C. <br /> � <br /> C/.���''� .� ��_ 5--`��- o� 12� <br /> 9i�7naWre Dale ���� I � <br /> ✓ <br /> / <br /> �% <br />