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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 'i200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��2"'7 (Z.� (��fY�T �Q <br /> PROJECT ADDRESS <br /> �'�� P�T ,�`� � �-���tfi- �2.��� ��� - <br /> Owner Mail Address City State/Zlp Phone <br /> Tenant Mail Address Cily StatelZip r 1 Phono <br /> 6V� 1�.� �lZ� <br /> ��aN �l.�S�. ('. c`� (?��� �1� Tr �?�o ?3� � <br /> Electrical Contraclor A9ail Address City Slate2ip Phone <br /> 1��flSS �� 1�3�R-� <br /> Sta�Lfcense Number Convact Price of Work <br /> ���1 �r�"\(�L - <br /> Proposed Use of Building Cor�tacl Person (Plan Reviow) <br /> Descriplion of Work l0 6e Dono: ��� Jc�— �� W 111�1 L ►vJ � "� ��'n^��� <br /> ���--T R-\Cf� L. ���'c_ ^�X'j , <br /> � (J{�J ��-r� o r�' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br /> 1 heraby cerii/y flmf I ha��e read and ext�mined Ihis applicntion and know fho samo to be We and �" u� ' I p3 <br /> conect. All piovisions of la�vs and ordinances go��emin�fhis fype ol work wi'1 be complefed <br /> �rhether specified he�ein or noL The granfing of a pennd does no!presume to give authonty fo <br /> violafe or cancel fhe provisions of any otHer stafe or local lan�rec�ulatine�wnstrucfion or the <br /> perlominnce of constn�clion. Thaf 1 arn t�ufhoiized by fhe onner o(fhis propc�rty to pedorm the <br /> �vork lor ivhich applicafion is m��de and 1 cornpl}�n�ith(he Slafe Cenfracfo�s Law 18.27 RCW and <br /> 29G.200 W . <br /> � 3/Z� / / ( <br /> Signa iue Date <br />