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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 — v✓ww.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />z I '� ) �v�G l ltiw`L �L,/L� <br />PROJECT ADDRESS <br />Owner / Mail Address Ciry Slate/Zip Phone <br />��1�� f� �'�t S�/JiL �� ?`�'�i; v�lc�aa't, .`�it��- �7�4f_ --�44-�4�ra c�`6�1 <br />Tminnt Ltoil AdC�oss Cd� Statc2ip Phone <br />Eleflfiral CUntrt7C�of Idatl Addic:<• <br />Stalc License Number <br />('� I I i�� l'� _ <br />Proposed Use of OuilJin9 <br />Dcseriplion of Work lo Ou Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Cd. <br />a <br />State/Zip <br />Conlract Fiir,e o( Work <br />Conlact Perscn (Plan Revicr�) <br />�� <br />1 hereby ceriily thaf 1 have read anA ezamined Ihis applicafien and know the same fo be frue and <br />conect. All provisions ollaws and ordmances goveming this fype o/ woiV�� �r;ll Ge cornpleted <br />whelher specilied herein or noL The c�ran6ng o! a pennd Aoes not presume !u give auCionty fo <br />violafe or cancel fhe provisions o/arry ofher s(afe or local la�v regulafin� constn�cfien or the <br />peAormance oI construchon. That I am authorized by the owner o(fhis property to perform fhe <br />�vork Por which applir.aliai is made and 1 comply wifh the State Contractors La�r 78.27 RC4V and <br />296.200 WAC. <br />---.��c�l� �, � 9/� /�7 <br />FEE <br />Ptwre <br />t- ('��C``� - C�� i <br />, ,. .,; <br />�,;�j�� !�^�fxr=, _ �YT�1•�`i�,1� � <br />_. -r i i�_- _ : <br />�- , � ... �" .`, �,�', ." _ _,� _ �..- <br />