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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 /> APPLICATInNS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ����-� `'(��tJ'� 711��`lJ�.lc c'���Y'�� �7 �?�:�j <br /> PROJECT ADDRESS <br /> ��1-5� 3�S_ <br /> �-�+,� ��������, 5�� �z3s�-� A,�-.�,,�_ �v�-�� 9a7��, �Z�z <br /> Owner Mail Address City State/Zip Phone <br /> �S�.v�E� <br /> Tonant Mail Address Cily Stale/Zip Phone <br /> GL�1�VG�(� Gy'J�1{�� �:___ <br /> ElectricalContraclor MailAddress City State2ip Phone <br /> State License Number ConUacl Price of Work <br /> �/t'_.�_�l�T��l��12-- <br /> Proposed Use of Buildin9 Contact Person (Plan Review) <br /> �-L���� e,�-n�_ v,�,�P� -� �'���� �-.,.�n <br /> Descri riion o(Work lo f3o Done: �- `. <br /> � <br /> -�'I7i7i I�Ji� :J�^ �J�/�C' <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> DE IIJ RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereb}�catil}�that 1 have read and examindd Ihis applicnfion and know fhe same to be We and <br /> conecL All pruvisions ollaws and ordinmtces govenung this type of work wi/l be cornpleted <br /> �td�efher spec�Ged herein or not The�ranfing o!a penwf doos nof resume fo give aufhonty fo <br /> viofafe or cancel(he vovisions o/an}�ofher stafe or local lew reguPting consfruction or the <br /> pe�fonnance ol cons�ruclion. Thaf 1 am atdhorized by fhe owner o/fhis property fo peAonn the <br /> work Ior�rhich application is made and 1 compl}�with the Stale Confracfors Law 18.27 RCW and <br /> 296.200 bVAC. <br /> l . /,_ , <br /> f�-1 =U�ss� � v�1� p(� I plC _�� <br /> l` � SignaWre Date I I � <br /> � <br />