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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PE�CMIT 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 />i7 �i," `�/� r'l y � �_, ,n, ,.-� � — <br />,�• ! i i 171- <br />PROJECT ADDRESS <br />i��l i}'c �t='9�— - .. ���' ^`v' C-" t—�l?- I �JF rJG? �7 <br />J" .=J�.-1�-�=� �lc.-,a� .�. �'✓�_��, �).'�i ..-. �_ � <br />Owncr � Mail Address Ciq� State2ip Phone <br />A1ail Address <br />GITC'� ��= 1=VE�1_� "� _ .: _�;. �. �,� <br />Eleclrlcal Conlraclor Iaun Hddress <br />-�-I � �' ��=C� �}-�*-( � <br />Slale License Mumber ' <br />.')t-n_i�- - <br />Propased Use of Duildin� <br />_ ,_,� . <br />Gty � <br />��f, .-r.�,� p-•-� 1 <br />1 . . � . . / <br />c'�ty <br />�'�'L–.�1�C�''� ;A�!!= <br />State/Zip <br />_� i.._ <br />I <br />si�i�-z��. <br />Conlrac� Fricc ol ANorY. <br />Conlact Person (Plan Revicw) <br />Descnplion o( Work lo �e Done: ��1%U �'("Li l-;�r� �-�f7.)� � -�T�� �/U�� � <br />_����=1lL `�� iV���T �IlLbIA.�- _ �7?; �1�2��? <br />NOl L': WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CF�DLE. <br />CITY OF C-VER6TT'.00AL SALES TAX CODE IS 3105 <br />1 heieby ce�7i/y Ihaf 1 have read and esarnined this applicafion and kno�r the sarne to be true and <br />cerrecL All provisions ol laws and orAinances go��errnng fhis t}�pe oI �rork �rill be comp/eted <br />�+�hefher spea6ed herein or noL The �ranting o(a pemuf Aoes nof �resurne fo give authorily fo <br />viola(e o� cancel lhe provisions ol any ofher stafe er local law regulafing construcLai or the <br />perfom�ance ol consfrucfion. That 1 am authorized by fhe cn�nei o� this property to pe�(onn the <br />�ti�ork !or rvhich applicalion is ntade and 1 comply �vifh fhe Sfate Confractors Law 18.27 RCL1' and <br />29G.200 INAC. <br />—��j,•�_ � <br />� , <br />�.;- ; m <br />,� <br />17 �� I/� <br />� <br />Phonc <br />Phone <br />