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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-vwuw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � 6 � -D <br /> _J � b 7 � ��k��=���� � <br /> PROJECT ADDRESS �LS-ZSZ�5 v <br /> P►�r� �2c� � ALI s� fl-,e��s l�f°7 �c�e�ErG������uJ�t 9 S: o� <br /> OWner Mail Address City Slate2lp Phone <br /> Tenant Mail Address Ciry Slate/Zip Phone <br /> Eleclrical Conlractor Mail Address Ciry Stale2ip Phone <br /> Stale License Number Conlract Price o(Work <br /> ��;,,_�-� ,�S;cJP�cc� P, <br /> Proposed Use oi Building Contact Person (Plan Review) <br /> Descriplion of W ork lo Be Dano: �\ �co 12� � C' � ��`l� � � `� e � � � 1? '�--J <br /> w �,�-, <; ,�1- � � n�� ,�l �� s � I � �� �,-f-s . A-� � �� �u�r�ls <br /> S,o S ; ,1 i,u�- )���-�- S�-r s�Yn — <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 3705 <br /> 1 Nereby certily fhat I have read and examined this application and know the same fo be true and <br /> correct. All provisions o(laws and ordinances govem�ng fhis type ol work will be completed <br /> whether speafied berein or noL The granting of a pemut does ncf Presume to give authonty to <br /> violate orcancel the provisions oI any oUiersfate orlocal law regmeting construcfion orfhe <br /> perlormance o!construcfion. Thaf I am authorized 6y fhe owner o(fhrs property to perform the � � <br /> work lor which applicntion is modo and 1 comply�vith the State Confrectors Law 18.27 RC W and <br /> 296.200 WAC. ^�O <br /> ,-��.,� �-2 �'�"�..� ,� ,s � � � ��g0 <br /> G <br /> Signalure Oa1e ' <br />