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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES / <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � —I ��W <br /> 425-257-8810 - FAX 425-257-8857 —www.eti•areitwa.org C 0 �o�-D�5 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��r S�`r. ,l��� '�?_5 <br /> //Soo [�i r��:�. /,�< .P� (���G��� <br /> � <br /> PROJECT ADDRESS <br /> �ife, .�^�'Q �'�'it� <br /> Own� Mail Address City Slale/Zip Phone <br /> Tenanl A1ail Address Clly State/Zip phone <br /> �/( <br /> Eledrical Conlreclor Mail Address Ciry Stale/Zip Phone <br /> �� 5 DO os- <br /> Slate License Number Conlracl Price of WorY. <br /> Proposed Use o(6uilding Contact Person (Plan Review) <br /> / i <br /> Description ol WorA l0 6c Donc: _ �Sy�.��/J�%'v ��r i.��..��.'/c%'�r .�s'�t�rn � r-7'C <br /> NOT[: WIRING IN NON-DW[LLINGS IS R�QUIRED TO FEE <br /> D[ IN RAC[WAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS:!'105 <br /> I hereby cerlily lltat 1 have reaAand exnmined fhis applicalion and know(he sanw fo be true and <br /> conecL /111 pr�visions ol laivs and o�dinances�ovcming fhis type e/work�rill be cornpleted <br /> �vhefher specilied herein or noL The granting ol a pemuf does nof presurne to give aulhon(}�to <br /> ���o/ale or cancel(he provisiens o/any ofher stafe or local la�v regulating construr,tion or fhe <br /> peAom�ance oI construction. Thal l am au(horized 6y'he owner ol ihis property to peifonn Ihe <br /> �rorh lor�rhich applicafion is rnade and I comply wifh fhe State Contracfors Law 1827 RClNand <br /> 29C,.200 Vl�AC. <br /> . ..� ---�-__-. .. � --' <br /> _�=i',�'.-'i;^i-- �/Y=Y.'-'Ci <br /> — ��- <br /> aSimi,�luie � " Dab: <br /> I /�✓ / <br />