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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �,; <br />3200 CEDAR STREET, EVER6TT, WA 98201 , <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />'�o� � 1,�1..i' � � ��! I('.,U 1� � <br />PROJECT ADDRESS <br />Owne: <br />Tenanl <br />����'�'�� �.�v� 'Vt��' <br />Idail P.ddress <br />A1ail Addross <br />Cily <br />qty <br />vii "sl ��'� <br />Slale/Zip <br />Slale/Zip <br />Phone <br />Phone <br />I - r� <br />�c�..��i.yi nr. % (��( l f 1^l C j �o� 2`�l Sf S li,.' L^'1 I-C/6�i(.� CvC� � bl%�l � ({Z� <br />[IuctricatContraclo� MailAddress City State2ip �thpneG�, <br /><,' <br />L<x�, �Q,� ���j t c G� <br />Stalo License Number <br />Proposed Uso o( �uildin9 <br />Descriplion af Work to �o �uno: <br />, <br />Y.TI-I:«' ,I, <br />;-, i�+ nl ��i � , <br />1 c n.��.- <br />s t- ('z�.-- <br />. i /ii / <br />NOTE: WIRING IN NON-DW[LLINGS IS REQU�R[D TO <br />BE IN R�CEWAYS, MC OR AC CA13LE. <br />) Zvo ov <br />Conlract Prico o( Work <br />Conlact Person (Plan Review) <br />C�rc,.c,+— r�-r- 1101�� <br />, �-z, <br />�. <o.• <br />CI fY OF [VcRETT LOCAL SALES TAX COUE IS 3105 <br />1 hereby certily Ihaf ! have read and examined fhis application :.-nd kno�v (he aame fo be frue end <br />rorrect. AO provisiens ollaws and orAin� nces yovemm� this fypo ol �rork will bo complefed <br />whe0ier specilied haein or noL The gianting o! a pennd does nof �msume to give authonty fo <br />violate or cancel 1he provisions oI an}� other statC or local law regu�ifing constn�ction or Ihe <br />pedonnance oI construcfion. Thaf 1 am aufhorized by the oirner ol ihis property to perfonn the <br />work )or which application is made and 1 compty �rith fhe Sfafe Con6actors Law 1 t3.27 RCW and <br />296.200 WAC. <br />/'' ,;- <br />C , ,� L. i _ <br />j . �� . /9� /� <br />FEE <br />_ �� � � <br />IC� <br />/ <br />