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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi', WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.c rg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /' ,/� 1� �'( CC /2��i/ P �r�ti=U���/� <br /> PROJECT ADDRESS <br /> J�n�r`��{ vs�,'l-/ � ?1� r �/l�u,L,;u e U�-�/�� G��-��,��r,� <br /> Owner Mall Address City Slate/Zip Phone <br /> � l 9 QQ�Z <br /> Tenanl Mai�Address City Stale/Zip Phone <br /> Eleclrical Conlractor Mall Addross Cily Stale/Zip Phone <br /> State license Number Conlract Price of Work <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Desr.ription of Work to Bo Dono: (l�J�' [��C/L l l��� � ���(c.� .+-( �Cic,i,I"/-() ,j� <br /> ����✓.J�C� .�I� (.r�t-P,.r.iY� <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R,4CEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> !hereby certify that I have read and exarnined th�s a�q/icafion and know the samo to 6e frue ana <br /> cormct All provisions of la�vs and ordinances�ovennng lhis q�pe o/�vork will ba completed <br /> �rhefher specified herein or noL The c�rantinc�o(a pernut does nof presumo fo give aufhonty to <br /> vialate orcancel the provisions olany olhersfate erlocal iaw regulefing consfruc(ion or fhe <br /> pe�formanc�o(construction. Tha(1 am aufhoiized by die otsner o(U� o prnperty fo pe�/onn fho � <br /> wo�k Ior a�i��ch applicafion is made and 1 cornpty wifh rho Stafe Contractors Law f8.27 RCW and I <br /> 296.2 O.1NAG.\ <br /> � � � � '� � �� , ' 1 �� , <br /> - � �1� �� �� <br /> i ign b�b � �-'Date <br /> � <br />