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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.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> T <br /> / ��� � `�eC'_ �� u�.c� . <br /> PROJECT ADDRESS <br /> �r;l�� ��ti��,�%L 7�.�( �,i� ���.� r� ��::/� yas-a.�2-39�� <br /> Ovmef Mail Address City StalelZip Plione <br /> —� <br /> / v �I ' <br /> Ten;lnt Mail Addre55 Cdy Slale/Zip Phone <br /> ci�rn ,� SS,���c��� �'�C <br /> E�eclrical ntraclor Mail Address Cily StalelZip Phone <br /> (�C;;� 1I>C�C '�k �:'�I �,� �� � Cs� ��' <br /> Slalo I imnse umber Con ncl Price of Work <br /> --� <br /> � � <br /> Proposed Usr of�uildiny Contacl Person (Plan Review) <br /> Dascription ol Woik to B�Done: _ —lf����C� ����"r^���" <br /> NOl'[: WIRING IN NON-DW[LLINGS IS RC-I�UIRED TO FEE <br /> 0[ IN RAC[WAl'S, MC OR AC C�CiLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 1 / <br /> l l�erubvi certdy that 1 have reaJ.vnA e.ramined this applicafion and kno�v fhe sanre fo be fn.e and ��`J �Ll - �';��� <br /> correcC All prov�sions ollaws and ordinances governui�fhis type ol�vork�t'rll Ge complefed <br /> whefhm speciGcd herein or noL The g�anfin�7 0!a perrm(does no(prosume to pive anfho�ity Io <br /> vio(ate or cancel the vovisions o/nn}�ofher sfate or local la�v regulatin�construcfiun or the <br /> pedermance:ol cons�ruction. lhaf I am aufhorized b}�thc�on�ner ol this property lo perlonn the <br /> nork!ur�rl�ich applicafion is rnade and 1 comply�rith the State Conf�aclors Ln�v 18.27 RClh�anA <br /> 291i.200 ll'AC. <br /> i <br /> t / / cr <br /> `� ' L � L� D <br /> -- �� � �� <br /> 1 tii�mauue Dat <br />