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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 /> � / c,uss <br /> IGi`�(� ��errt �l �'�Qek Nt�r�K1�l� SU��- e� - �—� �v-tf�� <br /> PROJECT ADDRESS \ , �S� G� ZO 2 <br /> w � ._� <br /> � �,�l.�Cs 1q30 �l�e,�:\\ ,��eeN �Arl'�I,.in�l <br /> OtvnC�� Atail Address Ciry Slale/Zip Phono <br /> �-C��-z ('A.S (�WV�-fs <br /> TCnan� A1ail Address Ciry State2ip r� q Phone <br /> _1� IZ <br /> �� Ccia�� ��e���.� "�-(,C- 3�-/ IOb' 1�7D+� A-lIC_ S �E A..t�o.�r��,J�S� <br /> Elec�ficalConlfaClol' A1ailAddress City State/Zip /�,�5.2\ 3 Phone <br /> l �l� q-NbIX <br /> �� (�E�. 1�C.� �L�L, (� = � �3.33 <br /> S ale License Number Contrect rice of Work <br /> �� �C-�. 0'1I�5�' . <br /> Proposed Use of Building Conlacl Person (Plan Revie�v) <br /> Description o(Work lo Be Done: ��(,L�C=(�lh.� (�� ' � � . �1/�� ���T C) <br /> � �V c-,2.5 r' : n'C" : � -=�g <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify Iha(f have read and examined fhis applicafivn and know Oie same to be true and <br /> correct AI!provisions o�laws and ordinances�overning thrs type o(�vork will Ue comp/eted <br /> ivhether speafied herein or noL The�ranfing ol a permd does not resume to give aufhonty to <br /> violate ur cancel fhe provisions ol any ofher state or local law reguPting constn�ction or the <br /> pedormance o/construction. That I arn authorized by the o�vner o(this property to perlonn fhe <br /> work lor which application is made and 1 comply wifh the Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �-- �' � I 1 � I 5 ��`7 <br /> �n.�<<�« u��o <br /> � C�� � -(�3 <br />