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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 <br /> <Z ZV �GX-�EFELLE� <br /> PROJECT ADDRESS <br /> 42S-?,44-91 �4 � -11� <br /> �tE,E t�,•vn LEQ <��o� �..�E� V Fw D� EvEeC� WA'�4'.2b� q2� 3�9 2Z39C �� <br /> Owner Mail Address City State/Zip Phone <br /> IA.1 �s..._1< 72�,U '�.tJ�cv�Ev_F�' �E�L=r W�1�9° "� O l •»S-E'SD�� '10} <br /> TenaN Mail Address Ciry StatelZip Phone <br /> �ELF <br /> Eleclrica�Conlraclor tNail Address City Slale/Zip Phone <br /> NIA <br /> Slate License Num6er Contract Price of Work <br /> �EN'rf�L <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descriplion o(Work la Qe Done: �E���E. \UhGa G�1YJ,: yF v�cF PalEl 4.1p 4�E�'E-L' RAS <br /> v��-�� NE�^� 2GL�A cx-n�.^ �v�cx Pa,.i � r�D MF�- gA;E <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CAB�E. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �I�)/'�� �� <br /> 1 hc�eby cerlily fhaf I Have read anAexarnined this applicafion and know fhe sarne to be tn�e and � V J� <br /> co�rect. l�II provisions o/laws mid ordinances govemmg this type ol u-ork�vill be complefeA <br /> a-he(her speciGed herein or noL The gr.vifing oI a pennd does not presume to give au(honty fo <br /> violate or cance/the provisions ol any ofher state or local law regula(ing consfruction or fhe <br /> performance o/consfruction. Thaf 1 am autho�ized by the owner ol fh�s property fo peAorm the <br /> tvork(or�vhiclt applicafion is made and 1 comply a�ifh Ihe Sfa(e Con(ractors La�v 18.27 RCW and <br /> 296.200 INAC. <br /> �' �k y � �� ,�.: <br /> . Signalurc , Dale <br /> � <br />