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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ��_� _O '7 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> [ o7ii-D33 <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br /> I S G t ���tC <<�-� Ati,_ <br /> PROJECT ADDRESS <br /> , � � � .. � � � 2uc � � v-^��r- �,,� `��;'`., � y25 <br /> �,J: ��r- , C�,�� r��- l�ol ! I �,,� �-- c. <br /> O�vnef Mail Address City State/Zip Phone <br /> S0� Z��� <br /> n wN�,Z <br /> TCnBfll Mail Address GN SIaIe-Zip Phone <br /> �u//�/�C_. <br /> Electncal ConUaclor A9ail Address City State�Zip Phone <br /> Slale License Number Contract Price of Work <br /> �,n�rG�: i: ,� r���;' . I��'R`: Coc('�i� <br /> Proposed Use of Building Conlacl Person (Plan Revie�v) <br /> Descripiion o(Work lo Be Done: �`�- " VV I(L� iVL �v i+'1=1 S�2 �7r�7!����� /j-q�7�/�7 <br /> �/11�7 5T797/�v� /�/��✓tok �co 5+' <br /> NOTE: WIRING IIJ NON-DWELLINGS IS REQUIkED TO FEE <br /> 6E IN RACE\NAYS, h1C OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that 1 have reaAand exarnined Ihis applicalion.nd knoa�fhe same fo be Irue and <br /> correcf. All provisiuns ollaws anAordinances�overnm�fhis type ol work�vill be completed <br /> whefher speci6ed herein or noL The granting o(a pennd do�s not resume to give authority lu <br /> violafe or cancel the provisions of any oll��er stafe or local la�v re�uPting consVudion or the <br /> perlcrmance o/construcfion. That 1 arn mdhorized by Ihe owner ol Ihis property fo pe�lorm fhe <br /> work lor which application is made and 1 comply with the State Contracfois Law 1827 RCW and <br /> 296.200WAC. /� �'� <br /> r <br /> / / / f `� � ,I ` , 7J <br /> - � ��� �9,-n; -'`-' �> % � <br /> Si�na�r{�' t� Uate <br /> i�� � <br />