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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 /> ��4\ <br /> ZrR �J��T �� i E w �2 <br /> PROJECT ADDRESS r�., <br /> �7 c-S, <br /> � <br /> —C�c� �'�Qc��(L� Zo3 ��v i e � D 2 S�'3Zo3 z.57-�5 <br /> Owner A9ail Address City State/Zip Phone <br /> Tenanl Mail Address City State/Zip Phone <br /> �-���1 �J ' cR`���lL � C� . (�5�7� �'/ � �c�TT S'@zol 33�3g� <br /> [leclrical CoNractor Mail Address City Slale/Zip Phone <br /> �'L�S '�' 1���� <br /> Slale License Number Contra.:t Price of Work <br /> I ?L'.-�, i )."���(. '\"' <br /> Pwposed se of Building Conlacl Person (Plan Reaiew) <br /> Descri��lion of Work to Be Done: �lN�I��2\ 71������ �ti�..���.E,�� <br /> s€R.�� �� --�� �Nr����o--�Nn <br /> IJOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> I <br /> � <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> '� !hereby ceiidy fhat I have read and examined this applicafion and kno�v the same to be Irue and <br /> rorrect. All provisions o//a�vs and ordinances govmning fhis type ol work will be complefed <br /> �tliether speciGed herein ornot. Thc gmnling o!a pernut does nol presume fo give authonty to <br /> i iolale or cancel Ihe provisiais ol any ofher state or local law regulafing consfruchon or Ihe <br /> pala�mm�ce ol construclion. That 1 am aufhorized by fhe o�rner o/Ihis property fo perlorm fhe <br /> n�ork Iar�vhir.h applir,afion is made and 1 cornply wi(h the Stafe Contrac(ors Law f0.27 RCW and <br /> zsazoo w . � <br /> Signature / � Dat—� <br /> (�p 7 St� <br />