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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �- —z""�� <br /> 425-257-8810 - FAX 425-257-8657—www.everettwa.org L J 00 Z-�l�S <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� � � ,M:,���� I/�-[w l�r. � �r F��tJ ,11r( ��, 5.: � 5��. 1,� , � <br /> PROJECT ADDRESS <br /> ��iV��" 1��.,1 i �_� �: VL 1j'=�C �f) .� • �' �ny: -�� �Vc i'{�_1 ��o;:�� .�� � ; <br /> Owner • hlail Address City � State/Zip Phone <br /> Tenanl htail Address Cily Slale'Zip Phone <br /> EICcIriCal COnUaclof A1ail 4ddress Cily State2ip Phone <br /> j jL.l <br /> Stalo License Numimr CoNracl Price of Work <br /> '� . , <br /> 41 (�L4C � lC�.�L-� <br /> Proposed Use of�uiloing Contacl Person (Plan Review) <br /> Descriplion of Work to Do Done: �(�� Sc'. � .e: �•. �e�� � � , S i o �, � <br />_� <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> D[ IN RACEWAYS, MC OR AC CACiLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereb}�cwlily tlm(1 ha��e read�nd examined this application and kno'v flie sarne fo be fruo and <br /> correcL All prorisior.s o/lan�s and ordinances goverrnn,q Ons lype ol reork will be cornpleted <br /> �rhefher specihed herein or nol. The�ranting o!a pemut does not �resume fo gi��e aufhonty to <br /> violate or cancel(he��rovisions o!��ny other sfate or local la�r re�ulating consWction or fhe <br /> performance o/cons niction. Th��f 1 arn�ufhorized by the owner of tbis property to pedorm the <br /> �roik!or ivhich��pplic��tion is mede and 1 cornply u�ifh the Stafe Conhpcfors Law 18.27 RC W and <br /> 29G.200 WAC. <br /> � / <br />_ ,. � -.� - �C� n .1'7 <br /> - Sig�alura��� ,`� � � Date j � i,� <br /> ;� `: � v �, <br /> , <br />