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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 ��09 ��� � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM i0 4 PM <br /> ,--' �.> �� — �>LGL'K� .l-� <br /> PROJECT ADDRESS <br /> �C�//l�� .�Fs/�d��x..�l� �t��1�f2�/ y szs8 <br /> ��'✓�1 Mail Address City State2ip Phone <br /> o�w'LC Qb� L%[�J-Oc'+�- <br /> Tenant A-0ail AAdress City State/Zip Phone <br /> '�/�i/ ; /' y-- l�> <br /> ��:l�c�Lf-�C� .�f��9"�� i«4�' <�c '/1GC l�fl1G/ zsL�9CC� <br /> Eleclrical ConUactor Atail Address �City S�ate2ip Phonc <br /> f��LL�/ 9z� C,'�D 4�/0�, -o <br /> State License Number Conlract Price of Work <br /> /lJll<t! �tG�1cc�-�1 /`1C�f-!�2� — <br /> Proposed se ol�uilding ' Conlact Person (Plan Review) <br /> Descriplion ul Work lo�c Done: ��t�C_� r�Atv`t�2 / �GG� �`���. <br /> � 2 C�6 z��d�� �� <br /> , <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 0[ IN RAC[WAYS, A1C OR AC CABLE. <br /> 7F7�-r�_ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I Aereby certil}�(hat I havc re�d and ez�amined fhis appiicafion and kno�v fhe same lo be l�ue and I� (~��('�� I!(' <br /> couect. Aq provisions o!/aws and ordinances governmg lhis type o/u�ork�rill be complefed J <br /> �vheflte�specificd herein or nof. The granting ola peinuf does nof presurne fo�ive authorif}�fo <br /> violate or cancGl fhe provisions o/any ofher sfaie or local law re�ulaling consfiucfion or the <br /> perlamance,�.!consl�urtiony lYiaf I artt udhorized by Ihe o�rner o/this property to perform the <br /> woik!or�vhibl�spplicafia�iy nV�de and�comply aith the S(afe Centracfors La�v 18.27 RCW and <br /> 29G200Wj1C. �' � r,., <br /> � %-c����� 9���9 <br /> SignoN'e Date <br /> L' <br />