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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, V�'A 98201 <br /> 425-257-8810 - FAX 425-257-8857—wv�nv.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> :s <br /> ��c� ?' � =� �jt� SC Un,I �- <br /> PROJECT ADDRESS <br /> (.�1! -«SNf_=� t"- n <br /> �t(�/C:i �C �� �/7i.%�L'S �.✓i'S� G:/f�� Sft"c7 s � i r : b L�-b� y '/>7/ <br /> Ov:ne� Idail Address Ci�y Slate2ip Phone <br /> Tenanl �.1ail Address City State2ip Phone <br /> EICCIfiC�Con�aC� M11ail Adtlic�s Qly Slater2ip Phone <br /> State License Number Conlract Price ol Work <br /> �.,-, �/c <br /> Propo:��d Use of Building Contact Person (Plan Reviev.) <br /> � <br /> Description o(Wark to Be Dona �r%�� tT��✓{Z _. <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FFE <br /> BE IN RACEWAYS, MC CR AC CABLE. <br /> i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certil}�that I have�aad and examined this application and know fhe sarne to Ge Irue and <br /> conect. All provisions o(larvs anAoidinances goreming this type ol�rork will be complefed <br /> �vhelher specdicd herein or not The g�anfin�o!a pernu(does not'nesume to give aufhority to <br /> vrolate or cancel fhe �rovisions olany ofher sfafe or local la�r regu ahnc�consfruclion or the <br /> peiformance olcons��uction. That I am aufherized b}�fhe owner o/this properi}�to perform fhe <br /> �vork lor which applicalion is made and I compl}�n�ifh the Stafe Confracfors Law 78.27 FCLN mid <br /> 29G.200 WAC. <br /> �.L✓/ —'� �'___ - �� ?_�= � _ <br /> Signature o� Oz'c <br /> Y : ��v -�.� � <br />