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ELECTRICAL PERMIT APPL[CATION <br /> CITY OF CVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �1 �� � '�� <br /> 425-257-8810 - FAX 4�5-257-8857 -www.everettwa.org / <br /> A' PLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � Cr^�� <br /> Lg � 3 l/��et (�/. ,, � <br /> PROJECT A�DRESS <br /> � " ' � � -� l 9��0.3 sso- <br /> �j S/ta� f 1 e��i /� � 3 ve��er /�r. 66 <br /> ,� <br /> OWner 61ai1 Addmss City Slate/Zip Phone <br /> Tenanl Atail Address Ciy� Slate/Zip Phone <br /> Electrical Contraclor Mail Address Ciry S' �/Zip Phone <br /> Stale License Num6er Contract Price uf Work <br /> Proposed Use of Buildin� Contacl Ferson (Plan Revie•:.) <br /> l �/'+ r, {I� <br /> Descriplian o(Work lo Bo�one: �h 1� !'Y / (°h ;7 � �J � �'i�a /l�9�Q l� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heieby certify ihat 1 have road and exarnmed fhis.�pplication and know fhe same fo beWe and <br /> r,orrec(. All pro�isions ol laws anu o�eiinances c�ovenung fhis fype of werk�vil!be cornpleled <br /> �rhether speci6e9 herein or noL The gra��tin�ol a pennd does nof resume to give authonty fo <br /> violafe or cancel fhe provisions ol any other sfafe orlocallaw reguPfing consfn�ction or tl�e <br /> perlomtance o/construcfion. That I am aufhotized by the o�vner ol Uus properfy to perlomi the <br /> werk Ior which applicafion is made and 1 compf}��vifh Ihe Sfafe Contracfors Law 1827 ftCL1'and <br /> 296.200 WAC. <br /> � ' � <br /> �. �- � /Y-o � <br /> SlgnaWre /% Uate � _ �� � <br /> �� <br /> �, �l ) , <br /> I,' <br />