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EL�LTRICAL PERMIT APPLICATIOI�` <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.ory <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> 1333 <br /> -,�j '�x,�c�-�-u.c 2 �J r�.:-�c °{otio�, <br /> PROJECT.4DDRESS <br /> I�JJ1Ol"N(ir ��3��cM, L��r-L �31� Co��sy l.=�Fn-c-r�' (1-!/� `��E"L°(� <br /> Ownef tdail Address f.ily Stale/Zip Phone <br /> Tenant Mail Address Cily Slate/Zip Phone <br /> �t.�ru� ��r-c�c« I��ctl �n,,:��;.y P� 1`J�JO Pr�Q 2`II 1�2�.�.��,r�J �,.� ��'iL7 <br /> Eleclrical Conlrac�or Mall Address City Slate2ip Phone <br /> uLT�c C2 �}(�i Nr �(o�,o <br /> State License Number Conlrect Price o(Work <br /> Proposed Usc o(�u�ldinc� Conlact Person (Plan Review) <br /> Descriplion of Work to Dc Done: �M n �E 2�1 Cc <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 hereby certi/y thaf I have read and examined this applicalion mid hnow the same to be hue and <br /> conect. All provisions of la�vs and ordinances governing this type of work�vill be cornplefed <br /> �vhefher specdied hercin or noL The,rranling ol a pennit does nof presume to give airthority fo <br /> violate or cancel the provisions o(any other sfate or localla�v ie�ulatin�construchon or the <br /> peAom� nce ol constnicfion. That 1 am aulhorized by the o�rner o(fhis property;o perlorrn Ihe <br /> woik lo vhich applicathn is made and 1 canpty u�ith tlie State Caifractors La�v 18.2i RCW and <br /> 29G.20 NAC. <br /> Yi/� /�lJ <br /> Sign�(ure Datc /�� <br /> /�l/ <br />