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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 /> `. <br /> � 'J� US ��l\1n\L�/ �,.)V1��, <br /> PROJECT ADDRGSS <br /> SC�v(�C�iV\Q,�) �Y��YG�C.�\V\ci ( l^�Z�t1 0 '�C� ' �?LI� <br /> Owner Mail Address City `State/Zip Phone <br /> Tenanl Mail Addmss Ciry State/Zip Phone <br /> � <br /> \M,� ���, �� �lu�:\Y�� G.� �c. ���2� ��Z� yB`1� <br /> � <br /> Electnc�l Contraclo Mail Address City Stale2ip Phone <br /> ��c �—�zN��-- C�lcG � 1v� <br /> Stato License Number ConUact Price ef Work <br /> Proposed Use ol Building Contact Person (Plan Review) <br /> Description of Work lo Oe Done: � �'� L��`�'Q �UL\r V v�U� �W�,� <br /> NOTE: W IRING IN NON-DINELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ll <br /> I if <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 l <br /> 1 hereb}�catily that I ha��e rend nnd examined Ihis applicnfion nnd kno�:the same fo bo true and ��C���'`� — V 1 c� <br /> com�cL All provrsions of la�vs and ordinances govemmg fhis frpe u(�rork u�ill be complefed <br /> whefher speaGeA hemin or net. The c�ronting of a penr;d does noll�resume fo gi��e authonty fo <br /> viulate or cancel the provisions o/any otl:er stafe or local law regu oting consVucfwn or fhe <br /> performancc�o/constiuction. Thaf!arn authonzed by the o�rner ol flus properiy fo pedomi!he <br /> work lor which applica(ion is made and 1 comply�vifh the Stafe Con6acfors Law 18.27 RCW and <br /> 296.200 INAC. <br /> ��, ' �� /�`� 1Z� i � O�' <br /> - �: � � <br /> " � di�natu�%` �� — Dale <br /> � <br />