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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� I �I 1�'(�,� ��- <br /> PROJECT ADDRESS <br /> 1 --: I '- '� �� �C. ��tc j-� <br /> � �,tL�.,� SL � � l C�� ��2tiCt ' �v�, z-��-� I.�.� N <br /> Owner —' Mail Ad� City Stale2ip Phone <br /> Tenanl Mail Address City Stale/Zip Phone <br /> � <br /> � ����c Y'_ <br /> EICCIfICaI COnlfaClof �dail Address Cily S�ale/Zip Phone <br /> Slate License Number Contract Price of Work <br /> Proposed Use o(Building Contacl Person (Plan Revie�v) <br /> Descripiion of Work to 6e Done: <br /> - - �n �1 � 'L. _ 1��'-1..� �� C,� v�� c � <br /> � �'� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> DE IN RACEWAYS, MC OR AC CABL[. <br /> CITY OF EVERETT LOCAI SALES TAX CODE IS 3105 <br /> i �� L � � <br /> 1 heroby certi/y thaf 1 ha��e read nnd examined this opplication and know the sarne fo be frue and � C- 1 I �. C, ( ;S <br /> correct. All provisions e//aws and ordinances goveming fhis lype ol�rork will be comp/efed <br /> �vhefher specilied herein or noL The granfinc�of a pernut du�s not resume to give aulhonty to <br /> violafe or cancel the provisions of any ofher state er Iccal la�r reguNting conshuction or the <br /> perforrnance o(consfruction. Thaf I am airthorized b}�the on•ner o/tlus�roperty to perfo�rn fhe <br /> n�ork lor nhich applicafion is made and 1 comply�vifh fhe Sfate Contracfors Law 18.27 RCl1�and <br /> 29G.200 WAC. <br /> 'il.�- 'rl-e.���r1C. (CCJ��i�_ ( �`�", <br /> �� � �CCI <br /> � ` , , � - �L.51 C � �-�� �.,., ,;;���'. , � << t <br /> � � t � ,� <br /> � ,_. v. � ,�>�J l-,�� 1 ,. .;�,� � l,. � � I -� � � �� � �`, - <br /> . Siyn.a�ure � _ , , , , i � �, { Date <br /> � � A��, ��1�,,: 1,_ I <br />