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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 FR0117 8 AM TO 4 PM <br />' l.;ZO'S yl�' �• Lt/ _ <br />PROJECT ADDRESS <br />Cy <br />Owner <br />Tenanl <br />Mail Address <br />Mail Address <br />Cily <br />City. <br />li)al� „sh >=.ir�/T'` .�i]�h��rS�, <br />EleclricalConlraclor A7ailAddmss C�ry <br />State License Number <br />Proposed Use af Buildiag <br />�escription of Work lo Do Dane: ��� � L�`'{ r�� �' <br />Slale/Zip <br />State/Zip <br />Statc!Zip <br />Conlracl Prico of Work <br />Conlact Person (Plan Review) <br />�G•1� <br />PIlOf1C <br />Phone <br />Phone <br />NOT[: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 heiehy certily ihat I have read and eudiminad Ihis applict3liun and kno�v fhe same to be tn�e and <br />con�ef. All prqvisicns ol la�rs ond ordfnances gm-enuny this t}7�e o! �rork �rill be completed <br />�•,IietherspeciGed herein ornoL The �r.inting o(a perrnd does nof msume fo gi:e aulhontyfo <br />��i�lafe orcancel the pro��isions o/an}� ofher state orlocal law reguPting consfn�cbon or fhe <br />perfonnance o/consinic6on. That 1 arn authoiized b}� the otsner o/fhis property fo pe�form ihe <br />irork (or wliich applicafion is made and 1 cnmply rvith tl�e Stafe Cen(ractors La�v 1827 RCW and <br />2sc.zoo wnc. �) 7 <br />� , —� � �� � �f `��� <br />- �_; � �-2,-„ <br />_ �,:,:,����� oa�a <br />