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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 / Z,�b3�0�� <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> �O�/2'-D�C� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> F�i r�'.1�= <br /> � � '� ��-�l,r�'�-c; f`t ��-� , ti3�8�9 �- 03(0 <br /> PROJECTADDRESS � --- <br /> J f-\�+n1_5 �;ii�����-� 2�� � �lAnnel+q /l..-c � MOn!7�J�Fl �-A . 110�Cv <br /> Owner A1ail Address City Stale'Zip Phone <br /> <'y2 Z) <br /> D!� ����,,1T`�e IG i'� �.r�Trn��< Av-t �- �� ��a. �Zoi z>,-� ���� <br /> Ten3nl Mail Address Cily State2ip Phone <br /> [leclrieal Contraclor hlail Address City SlateiZip Phone <br /> Slale License Number Contract Price of Work <br /> I '�t�G �1-s�� <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> Description ol W ork to�e Done: ��. (_�� � T D f. l nC�.��. � L�1�( A r;�C <br /> NOTE: WIRING IN NON-DWELLI"'GS IS REQUIRED TO FEE <br /> E3E IN RACEWAYS, MC C. '.� CABLE. � � �U�� <br /> i <br /> CITY Of EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereGy certily thal l have read i�nd ex�amined this applicnfion and kno�v the same to be fn�e and <br /> conrct. All provisions o!la�vs and ordinances go�-emm,q this type o/work will be completeA !, �I/ <br /> whefher specified herein or noL Thc granfin�ol a permrt does nef �resume fo give aufhonty fo - ��;I � U�`I� <br /> violale or cancel fhe �ro��isions olany other stafe or/ocal la�v regulafing consfrucfion or fhe ���.� � <br /> perlomiance o!cons�niction. That 1 am authoiized by ttre o�sner ol this pmperty fo pe�form!he <br /> �vo�k!or which applicafion is r iad and 1 comply wifh fhe Sfate Con6actors Law 18.27 RCIM1'anA <br /> 298.200 WAC. <br /> , `_ = 1 <br /> _ ��.; � - <br /> , , .�_ ,, _ ; , � _ -� _ �, � <br /> l <br /> Sl�natu,e Date � <br /> __ _—.__— —_—___—_ _ --_ —� <br />