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EL�CTRICAL 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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��L� �� ��`Lvll vl ; �Y <br /> PROJECT ADDRESS <br /> �re,�rt- <br /> � c�_�� l��d-}—��`" `'Z,,� •,- ��Pc c;,-� - �CI�2 J1C�� 1 r - �f��/i� �s2�-j <br /> Owner Mail Addr ss Clly ale/Zip Phonc <br /> �-iz�.� - �:� - a.3�s <br /> Tenant A7ail Addross City StalelZip Phone <br /> �y��i <br /> �� <br /> F!o!:trical Contraclor Mail Address City SIale2ip Phone <br /> State License Number Contract Prico of Work <br /> � � � <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> Descriplion ot Work�o�o Done: ��t' �,.� `r''Z �"�� ��",�' � �"'�^ � M���`^��1 <br /> ,Z> I �� � ` � '111'1/� .. ✓�. Ot� <br /> � <br /> i NOTE: W IRING IN NON-DW[LLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 O <br /> 1 he�eby ceiti(y that 1 h�ve read and examined fhis applicetion end know the same to be frue and �� � LL� —U ( 2 <br /> conecL All p�ovisions olla�vs and ordinances govemmg this fype ol�rork will be complefed <br /> whefher speciGed herein or noL 7he granfing o(a perntd does nul �resume to give aufhority lo <br /> violafe o�cancel fhe provisions o�any other state or locallnw re�ul3fing consWction or fhe <br /> perlormance ol consirucfion. That I ant atdhoiized,by the owner o(fhis property fo pedorrn!he <br /> work Ior�vhich applicnfion is mnde and I comply w�fh flie State Contractors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> ,� � � <br /> �� �;� , �;,1�' �� „����..�_`j� ���� c�U � � <br /> S�natme L�� Date <br />