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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 /> o�S�i� �2(,<Gl�brL �tJ d-- GG-� ,�f 3 <br /> PROJECT ADDRESS <br /> T(/ �.Ul C .S �f/ S AfffG (.4t�1,� �� V�Jc`'./1 b[�I� W�',S l� <br /> i <br /> Own r ldnil Address City StatelZip Phone <br /> �JNNL>2_ _ _ <br /> Tenanl I.1.+ii�ddress rd�� Slale2lp Phone <br /> L Q C �-7 C>L �Sa1Z 12G!l.�rot �Q-t�C( �y/6/t� GU/i- C1¢L�/ <br /> Eleclrical Conlraclor Mail Address Cily StalelZip Phone <br /> E2�cL <br /> ���G �-� G 3 S G G -louz l- <br /> Stale License Number Contract Prir.e of WorY. <br /> Rb�10an��vt �_ �rA_ • �'- �n3-6��3 <br /> Proposed Use o(Buildinn Conlact Person (Plan Review) <br /> Descnption of Work lo Oe Do•ie: L�= ,(.k.�_I_E> S�,�j PIJ�,� �S(hCC ��#�n��t `�0 ' � <br /> ��'�M W� J�1C��1 � �t.g� <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> B[ IN RACEWAYS, MC OR AC CAOLE. <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i� 1 hereby ce�ii/y Ihal 1 have read und examined this app�ication and know the same to be true nnd <br /> corr�cL All�rovisions oUaws and ordinances c�orerning fhis t}�ne o!�rork will br, cr,rn�fafed <br /> whether specilied herein or no1. The granlin�ol a pennd does not �resurne to yire,uthonfy lo <br /> violafe o�cancel fho provisions ol any ofher s(ate or local I��r regulating construcfi.,n or fhe <br /> pedommnce o/const�uction. Thaf 1 am authonted by the o�sner o/(his property fo perlonn Iho <br /> ❑�ork lor ishich applicalion is made and 1 comply�rith fhe Sfote Confiacfors Lew 78.27 RCIM1�and <br /> 29G 200 l4�AC. <br /> ..-- —�� ��� <br /> �' /� J T�1 ( , Ld�� b <br /> `���— ---- � — - <br /> — ��s��,��:,i�,m o�i� <br /> � � � r�-, <br />