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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVIC�S <br /> 3200 CEDAR STREET, EVERETT, WA 98207 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �(� �J .1i� i/�i�S - v�tE� Y ,/S�v�� ��tii" E /�, <br /> PROJECT ADDRESS <br /> l/<'A�C y /�sSO� <br /> OWnef A7ai1 Address Cily 6tatelZip Phone <br /> � OGti/� �? !� �DNCS _T�llvt'1`i/GlL,c�%S <br /> Tenanl Mail Address City 91ale2ip Phone <br /> Z�r� ����ti�� �_�E����� ��y �y� ��� P� S�U �.�,�ti�o,�,, Lti /� y�D�� <br /> Eledrica!CoNraclor MailAddress Cily Sta�elZip l�ZS'- 77� PhongGX <br /> — /O <br /> l �� l l��T L l l3� �3 Svo, �z� <br /> Sla�e License Number Conlracl Price of Work <br /> �i�/�I�'I F-��� /f)L <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> ����T� � .� �/CC1 ' — <br /> Descriplion of Work lo Oc Done: � �. /V/ �4 v��1� �� � <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CA[3LE. <br /> i'�I�� � �� <br /> CITY OF EVERETf LOCAL SAL[S TAX CODE IS 3105 <br /> I hereby ceriily fhaf I have rc-ad&nd exarnmed fhis applic:�fion and kno�r fhe sarne to be frue and <br /> correct. All provisi�ns o(la�e�s and a�inar,ces got���nung fhis type e!a�oik will be compleled <br /> �rhefher spea6e herein or nof. ihe grantinp of a��ernuf does not presume fo give authonty to <br /> violafe or cartcel �fie Ii visions o/any ather s�aie or local law regu/efing construcfion or the <br /> perlonn�t�ol nsf�ction. That I am autho�ized b��ihe o�rner ol fhis property ro pedomi!he ��.�--� ,�' <br /> �rork Ipfwhid�a-plication is madr�vid 1 cornply�rilh fhe State Confraclors La�v 1827 RCl1�and ��` � <br /> 296.,ZD0 WAfd: � �' „ �/ <br /> // / �/ <br /> � ,�� � �� � 03 - /3 , �6� <br /> �� ure Date <br />