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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 /> - ! �� ,? G(.�C.%/ri�'�-L� /f✓cJ <br /> PROJECT ADDRESS <br /> ��� �����,�� ���� �o��-� .���N� �.� . ��::, yy�vj .�o� -x3-����, <br /> Owner Mail Address City Stale/Zip Phone <br /> Tenan� Mail Address Cily Stale2ip Phone <br /> � ,l�.v'Y1QSf <br /> ElectriC3l Conirec�or hlail Address Cily State/Zip Phone <br /> Stale License Number Contracl Price of Work <br /> `��"f�� <br /> Proposed Use o1 Buildin� Contact Persnn (Plan Review) <br /> Descriplionof Workto �e Done: ���� �'� ��t'�✓'�'--�i% er ���i��' i�itoM �L�LU��C- �L7i}-j j <br /> i <br /> %Z 5E_-�c� �lc: iSoX <br /> NOTL': WIRING IN NON-DWELLIIvGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 L C��' �7 _ ���� <br /> I he�eby ceitify fhaf 1 have read and exmnined this applicafion and know fhe same fo Ge frue and � <br /> corrocL All provisions ollaws anA orciinances goveming fhis type ol work will be complefed <br /> whether spealied herein or noL The granting��(a pe�nuf does nof presume fo give authonty fo <br /> ��iolatc or cancel fhe prov�sions ol eny other s�ate or locnl law iegulating consWchon or fhe <br /> pedomianr.e ol conslruction. Thaf 1 am aufhonzed Ly fhe o�rner ol fhis property fo pedorm fhe <br /> work lor wRich�pplication is m��de and 1 complp�rifh fhe Stafe Confracfors La�v 18.27 RCIh'and <br /> 29G.200 N�AC. <br /> ` ��L i�'I�Lt/J-{)"''L� �� / �'�' <br /> 5 nature Dat <br /> � <br />