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EL�CTRICAL 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 3 �p y �O� <br /> . �- <br /> � � �� ��CiVi �U �N��n �'�' C� r <br /> PROJECT ADDRESS <br /> � <br /> P _ � i.� �i7 /' <br /> �;p.� „ ,�. . 7Z�'� N1= /S, S��- h�r�.�r v�� �� �'�'�� <br /> Owner Mail Address City � Stale/Zip Phone <br /> Tenant M17ail AAdress City Stale2ip Phone <br /> ruyZl S�� Pcl� <br /> �•�������E 1_=1�c�i�r41 ���v?rJ �n�. �12c' 1{-t'v�.,�1 �� �I�"U� �LJ'�I�f• Gl� <br /> Electrical Coniractor Mail Address City StaleiZiU Phone <br /> (� C' z ' � �0 G ���� �G� � <br /> State License Number Conlract Price o(Work <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> ( � <br /> Description of Work to Bo Dane: �I1��1 I( �—Q C,vi„�/-J 'h,/r1G C(' �I f ( V�� — <br /> �n t �l, �� .�i� C 1 /� �J l�C'��� � � rC v+ 1� <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 6E IN RACEWAYS, MC OR AC CA�LE. <br /> CITY OF[VERETT LOCAL SALES TAY.CODE IS 3105 <br /> 1 hereby certily thaf I have read and exnmined fhis oppllcalron and hnow fhe same to be frue and <br /> conect. All prowsiens o/laws anAordinances,qovernmy fhis fype o��vork will be cornpleled <br /> whelher specilied herein or noL The granting o(a perrnrt does not resume to pive aufhority fo <br /> violale or cancel fhe provisions o/any olher slate or locallan reguPting consfruction er Ihe <br /> performance oI construction. Tl�af I am airthorized by tlte owner r�l this property to peAomi fhe <br /> work lor�rhich npplicafion is made and I comply wilh fhe Sfute Contracturs La�r 78.27 RCW and <br /> 296.200 WAC. <br /> —--- <br /> . - _ � cl . _ 3�ti/ G 6 <br /> SignaWre ate <br /> �li(6�L- 3—�>`{� <br />