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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.evereitwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 P�' <br />`ro`�o y�'`� �� s � �v��:�;� r.,�� ��a��; <br />PROJECT ADDRESS <br />��!�.tJ �r't l�ot.�L� `> 4G j�_, �r�l (�L 5� £'�t:i �Jk 4''�o?OcS <br />OWner Atail Address City Slate/Zip Phone <br />Mail �ddress <br />��tijF C,, ��t% ,�1� (� <br />Electric:31 Coniroclur 61,�it Addicss <br />State License IJumber <br />Proposed Use of �uilding <br />�escriplion o( Work to �e Done: <br />NOT[: WIRIhJG IN NON-DW[l LINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CAE3LE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />� <br />���5 3 S J' 1'( � <br />Stale2ip <br />Slole/Zip <br />Conlracl Price ol Work <br />Conlact Person (Plan Revicw) <br />1 he�eby certily thaf I have r�ad and examined fhis applicatiun and kno�v fhe same fo be true and <br />cerrect All provisiens o! la�ti�s and oitlinances oovurmng this tppe of work �rili be cor.�pleted <br />n?mther spca(ioA herein er noL The granting o! a pmnut does not �resurne fu give aufhonty fo <br />violnfe er cancef (he �ievisions ol an}� ofher slate or local Imr regu�afin� cons6uction or fho <br />pe�fonnance o/ cons�ruction. Thaf 1 am aufhorimd by the mrner o/ fhis pruperty fo pedomi fhe <br />u�ork (or �vhich applica(ion is rnade and 1 comp, j n�ifh fhe Sfate ConUucfors Letv 18.27 RCW and <br />29G.200 WAC. <br />/\ ��.�{-u <br />fEE <br />L <br />Phonc <br />Phone <br />�0`tIZ-13�I <br />