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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES i8,�� <br /> 3200 CEDAR STREET, EVERElT, WA 98201 I `" <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org �. //�/r�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � !C-� L' C�).:- � D,i� / C/�' <br /> PROJECT ADDRESS <br /> ¢�'_ — <br /> /3%'��f� ti/ !C'��/��y(.. . fi�G"�"' �i�,�- 7�DL'— i.= i���/.°i`7 lt.rhi 5'Sz2/�3 353 -s rlvl <br /> Owner Mail Address City State/Zip Phone <br /> �i41 Fl ["'' <br /> Tenant Mail Address City Slate/Zip Phone <br /> ai-�' <br /> r�l / C ' O' G�/v - `37 �� �.(}��-ff G,VP1N:M��.r- LL��C! 9�1�9h L%�'-4�Z�il. <br /> Eleclrical Conlraclor Mail Address City StatelZip Phone <br /> f=� . � '� > ��-�c�y _ <br /> Slato License Number Contract Prico of Work <br /> � <br /> 3.�'-.ti <br /> Proposed Use o(Building Conlact Person (Plan Review) <br /> Description ol Work lo Oe Done: ,%�/ ��/ ,�-����v,C�%p" �.t!f'i� T ��1" � <br /> � ' - �L �C,4 r G' ' �".c,�i <br /> NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO FEE <br /> B[ IN RACEWAYS, MC OR AC CAF3LE. <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 �I I �J I —��3 <br /> I hereby certily thaf 1 have read and examined fhis applicafion end know fhe sarne to be fn�e end <br /> conecL All provisions o�laws and o�dinances goveming fhis type ol�verk will be comploted <br /> whefher speulieA herein or noL Tlrc�ranfing of a perrmt does nof presume fo gire aufhont}�fo <br /> violafe o�cancd the r�rovisions ol any otl�er state or local law�e_aulating constnichon or fhe <br /> perfonnance o/conslruc(ion. Tha(1 am authonzed 6y fhe owner ol fhis property fo pedomt ffre <br /> work lor whicfi application is made and 1 compl}��rifh fhe Sfate Conhacfors Law i827 RCW and <br /> 29G200 l4�AC. <br /> ��� .� � <br /> C � i.:,c- � i � " - %,�iS���'; <br /> Signature � ���� <br />