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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 � Z��O ` IO <br />425-257-8810 - FAX425-257-8857—www.everettwa.org ���b�2_�,Y'J� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��0"3 /��hnvC—.�ii �v� ��i��:;7 c✓9 <br />PROJECT ADDRESS <br />�/7_ S <br />3rF- �q y � <br />/�.�lCK /<n1=�2-Y�, ��03 ��ci��<�cro�. �� F�C,�� ^•-r- �f�/ 5 <br />Owner A1ail Address City State/Zip Phone <br />Tenanl <br />Eloclrical CoNraclor <br />Slalo License Number <br />Use o( Building <br />A7ail Address <br />Mail Address <br />Cify <br />Cily <br />Slale/Zip <br />Stale/Zip <br />Contracl Prico of Work <br />Conlacl Person (Plan Re+iew) <br />Descriplion o( Work to Do Dono: _/ZEi^'�o�� r'!Ec r,:ii.� c .� iNSi'e� � <br />NOTt: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RP.CEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ccrtify lhaf I have read enAexamined this applicntion mid kno�v fhe same to be truo and <br />corrocf. All provisions o/Imvs and ordinances govemmy fhis t}�po oI work �ri116e complefed <br />�ahefher spec�fred herein or noL The �ranfin� o/ a pennd does nof �resume fo give aufhonty to <br />violale or c�ncel t/ie provisiens o(any other state erlocalla�v regu��fing construclion or fhe <br />performance o� construcfion. Thaf 1 mn aidho�ized by the o�aner o/ this property fo pe�form the <br />�rork lor ivhich applicntion is mnde anAl compty �sifh fhe Slate Con6actors Lau� 18.27 RCW and <br />29G.200 WAC. <br />_�-� , <br />l � ��� /oDF'c zo,�� <br />si�nalmo ' Dato <br />FEE <br />Phone <br />Phone <br />��'-." I U 1 Z- C'•�; ( <br />