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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 �; � al-U� <br /> , c-o�c>e -, Zy <br /> �" ��>`� �� N�1,V���2 �1VE <br /> PROJECT ADDRESS <br /> Owner Mail Address City State2ip Phone <br /> _ n'�'� CO�St�U�17c�ti _ _ <br /> TeNeFlI-�U�ID� �O�V�t�'jC1A' �4ail Address Cily State.2ip Phone <br /> . �-(7S— <br /> �� �E=C�1C , _s�C�7_ lC�s�{Sfi Sr W�C'��1r k!(1- �5'Ze� ��'�� , <br /> EleClriCal ConlraClor Mail Address Cily SlalelZip Phone <br /> PCZ-D�[�L � �� �� ���,� <br /> Slate Li:ense Number Contract Price of 1"✓ork <br /> �����S iD�n�'i�i"-��� SOC C_l+z-'� <br /> Proposed Use of Buildinc� Contact Person (Plan Revie�v) <br /> Descriplion of Work l0 8o Done: ��.iS, tl����()�U 6� ����� � ` v�-��� �)[.�. <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> DE IN RACEVYAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereGy certily fhaf 1 ha��e read and exarnined fhis applicafion and kno�r the sarne(o be tnie and <br /> correct. All provisions ollaws and ordinances goveming fhie type ol u�ork �rill be completed <br /> whefher spea6ed herein or noL The granfing ol a pennrt does not presume to gi��e aufhonty(o <br /> violafeorcanceRhe provisronsolanyothersfateorlocalla�vregu/etingconsWcf�onorthe <br /> perfomiance o/constnicfion. Thaf 1 am aufhorized by the owner o/fhis property fo pe�fonn fhe <br /> �vork(or which application is made and 1 comply�rifh the Slate Contractors Law 18.27 RCIh�and <br /> 29G.200 WAC. <br /> �, ,� <br /> - r' I <br /> �� , � �� (� -z( -e��� <br /> , <br /> � Signa u ,/ Date <br /> i <br /> _ ' � � � r=����G, -1� y <br />