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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 B AM TO 4 PM <br /> �l1 <br /> '�Z/o / �-v� .�G' L-'c/G-!'�� <br /> PROJECT ADDRESS <br /> (,�r� l�:,� �.;� �L:X'/,�vLE` j/r•�'L� <br /> Ovmer Mail Address Cily State/Zip Phone <br /> Tenant A7ail Address City StalefZip Phone <br /> ��/,��5 ELG«i/-';� L[t 1�,� �,r��i�-k� �i� , /.�ic�GS�rvr,�j bt!/r `�}':-r:! .c�?'y`-3��1�c'e <'- <br /> Electrical Contracl0r Mail Address City Slate/Zip Phons <br /> �'/�r-S��Y-�>��2 JG <br /> �'! SZn <br /> State License Number Contracl Price of Work <br /> Proposed Use o(Buildin� Conlacl Person (Plan Review) <br /> Description of Work to 6e Done: ����'��� � �7'��v��' (' �r''t���l`� <br /> NOTE: W IRING IfJ NON-DWELLINGS IS REQUIRED TO f EE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY Of EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heieby certi(y tliaf 1 have read e�nd examined this application and kno�v Ihe same fo be fnre and <br /> corroct. All provisions o(la�rs and adinances governmg fhis type ol work rvill be completed <br /> �shefher speci6ed herein or noL The granling o!a pemut does not �resume fo give aufhonty to <br /> viofafe er cancel the`n�ovisions o(any ofher sfafe or/ocal la�v re�ulafing consfruction or the <br /> pedormance o/consiniction. Thal 1 am authoiized b}�tlie ou�ner o/this property fo perform�he <br /> �vo�k for n�hich application is made and 1 cornpty�rith the Stafe Contractors Lan� 18.27 RCW and <br /> 29G.200 WAC. � '' ' � _ /��D <br /> 0 <br /> ,�� r�� r�� �� ������� � <br /> " Si3nalure Dalo <br />