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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 q _�p_O� <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org � <br /> C o�o,�o aq <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ���1�� ..S�E�N� ,� v�- <br /> PROJECT ADDRESS <br /> 6����/ / '�C ho�- yCf��Sr�."'!7 /¢�� �vCiC�77- �✓ia <br /> Ownet Mail AEdress Ciry Slale/Zip Phone <br /> Tenanl Mail Addross C�y Slato/Zip Phono <br /> �11 r`U.S�it �CcG� -�NC � 3�� �, y'- � <br /> �' ,�a3c�-� ....••".o�n G✓ � `1' Fo3G, G�� .� • S6y <br /> Elec0iql ConNactor Mail Address CAy Sete2ip Phono <br /> in� � Tci S�.�� �.;� � c� <br /> 'State License umber Contrad Pnce of Work <br /> P���c•..� <br /> posed Use of Building Contact Persan (Plan Review) <br /> DesaiptionolWorktoBeDono� �'�,`"V-Z G�C1Q'?�-t/J �t� T (�clu4 �00 �� <br /> � <br /> ��9ar..tr_L1c�� <br /> NOTE- 'NIRING IN NON-DWELUNGS IS RECIUIRED TO FEE <br /> BE IN RACEWAYS MC OR AC CA6LE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � C �J ��� �- .� �/ <br /> 1 hereGy mrtdy fhet I heve reed end ew..mined fhis eppbcehon end knaw fhe sanm to be We end � <br /> conect All provrs�ans ollp�vs end ordmences goveming fhis fype o/work�rrll be mmpleted <br /> t:-hefhe•specdied herern or not The g�enhng ol e pemrrt docs nof presume fo give aufhonty fo <br /> violate or cencel fhe pmwsions ol eny ofher stete ar locel le�r regulebng conCructron or tha <br /> perfomiance of oonsfrucfroa Thet 1 em euthonzed by fhe owner ol(his property fo pedorm fhe <br /> n�ork!oi whicR�ppbcefion�s mede end 1 comply wrth the Sfete Conlrectors Lew 1827 RCW end <br /> 296 200 WqC. ' � <br /> ��J/� <br /> �'•;'' � � ��lz�%t( /� 5��'O� <br /> Sgnatme Date <br />