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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 /> �i.� z � ..?,��� � ��C S r t���, � �T � a % z <br /> PROJECT ADDRESS <br /> Cc'����T ..�. .� :j'n �_ �__. S r r'�n1 ��.Ci.,.�c- � <br /> OWncr IAeil Addrecs City State2ip Phone <br /> Tenant L1ail�ddicss Ci�y StatelZip Phone <br /> �. �-l2S-525 - -725 <br /> -Sv��ck�� elt.• c.�-r: L. l� v. a��C 3 �s1 .4.Irv��; ,-��.� w.4 rsZz3 <br /> � <br /> Elecirical Co lraCtor Mail Address City State/Zip Phone <br /> �.�,��Ic� �-� c�3 C�k <br /> Slale License Number Conliacl Pnce of Work <br /> �i �v S ���a� f f-.A ✓v�,t� �/ �eS• ._(..�,,�'� <br /> Proposed Use of B Idinc� Contacl Person (Plan Review) <br /> Uc;criplion o1 Work ta 6e Uone: J.�f� LtJ S7 t�c � � �--,ri rv�� ( �/ l�t-c� � �( �v� F' ���'4 <br /> � � . �^L � C .� " � �V� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CADLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf 1 have read and exarnined lhis application rnd know Ihe sarne to be frue and <br /> correcL AN provisions ollaws and ordinances goveming fhis typo ol work will Ge comple(ed <br /> �vhelher specified herein or noL The c�rantinp of a pemut does nofl�resumo fo give aufhonfp fo <br /> violafe or cancel the�rovisions o(an}�olher sfate or local la�v regu afing consfrucfion or the <br /> perfoimance oI cons(ruction. T1iat 1 am euthon.ed by the oaner o(fhis property(o pedomi fhe <br /> work lor which applicatiun is mnde and 1 comply�vith the Sfate Contr�cfors Law 18.27 RCIti and <br /> 296.ZOO WAC. � � <br /> ��, � j^ ,� <br /> y�-y- �� � <br /> _ _. ��Y.: , .c>-�� .�, '<'� <br /> ' Sinn:�tUfr. � Dale - ��(�� � �� <br /> j <br />