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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi', 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 �c� 1 P�K��6Z��L.�2 <br /> PROJECT ADDRESS <br /> �-}CD 1 C� � `�1� S�'S`'v <br /> �� �N o � f-� �rn�n� m���< i �-r� G 9�2�5 ��s-=�ti�-- <br /> Owner Mail Address City Stale/Zip Phone <br /> Tenanl Mail Address Cily State/Zip Phone <br /> 1 ��f�SS l�l �L�L.1�lL Q � l�?i�� 7� ��(L�`jf �ZiJ�o <br /> --�- <br /> ElectriCal COnlraClOr Mail Address Cily Slale/Zip Phone <br /> ���5���� � ���--�.,� <br /> Sfale License Number Contract Price oi Work <br /> I��US� <br /> Proposed Use of Building Conlacl Person (Plan Reviow) <br /> v p D�-�. <br /> Descriplion of Work l0 6e Done: � L_�� � O� � 1�� ���0`1 � �� <br /> �/1 N�� <br /> \ NOT[: 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 /> n� ^r <br /> 1 hereby certily that I I�ave read and examined this applicotion and know fhe sarne to be fruo and � ! r+/'�G? - i <br /> corr�cL All provisions o(Imvs�+nd ordinances govenung fhic type oI n•ork�vill bo comp/efed <br /> trhefher spea6n,d herein or noL The granting oI a permrt does not resume to give aufhonty to <br /> violafe or cancel fhe provisions o/an}�other state or local la�v reguPting construction or the <br /> pe�forn:ance of conslniction. Thaf 1 arn aufhorized by fhe o�rner o/Ihis propeAy to pedam the <br /> �vorklor whiC��application is m��de and 1 cornpty n�ifh the Stafe Contmctors Law 18.27 RCW and <br /> 296.200 W/+ . —`--- <br /> ` �� � /z � / o <br /> Signature ato <br />