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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.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 6 —a) —U7 <br /> � � � ��0-706-� z3 <br /> � _� � � ��q 1'�11�L �(�t'�� <br /> PROJECT ADDRESS <br /> Owner Aiail Address City Slale2ip Phone <br /> �n�v� �,�;Sy-t'l� �z�7�.� <br /> 'ftjne�S CC�nFs��`'��- A1ailAddress Cily S�ale/Zip Phone <br /> ��:i�o„"j �{��? — <br /> �(> E��C'tT'- 1� LLL 7'i i�' lC��� 5T'Si= F�-t�.E1"1— tJR- c(S2C� �� _ <br /> EleClrir;��CoNraClof M11ail Address City Slale2ip Phone <br /> (��C� C�LLL�1`�.� l-�I� ��-� - <br /> Slato License Number Con;recl Price o(Work <br /> �r��l��C�vj�( _ ��r`)F C�_� <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descriplion of Work lo De Done: ��SI�"t-� �.�'� V'��t-�-��-� I-[iLE __ _ <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RAC[WAYS, MC OR AC CADLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily Uiat I have read and examined fhis applicafion nnd kno�v(he same to be tn e and <br /> correcL AN pr�visions ollaws and ortiinances governinn this fype ol�rork �rill6e completed <br /> whefher specdied herein or noL The granting o(t�permd Aoes not �msume to give authunty to <br /> eiolafe er cancel the �rovisions o/any other stale or local Ims re_nulnting construchon or the <br /> perfo�manc�o(cons�rucfion. Thaf I am authoiized by thi�owner o/this propert}�to perfomt fhe <br /> �tinrk Ior which applicafion is ntade and 1 contply�rith the Sfate Confractors Law 18.27 F�CVI�and <br /> 296.200 WAC. <br /> 1 ,�� <br /> � � i / <br /> ��'..✓_ ,�;� �t L L l ��� <br /> --` Sipnatur �� � Oate <br /> / .- <br /> � / <br /> '.. .' CC�L.�tJ -�L�J <br /> L <br />