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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES t� _Il, � 07 <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org C d� b�( -l2� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� � ���, ��`N� 1 � � <br />� � �=1� �R� � \ <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />^�- <br />Mail Address <br />Mail Address <br />�� si 11) � , �J `, <br />City <br />City <br />4$J?2 <br />�Ovi 41f! . 3 ao � 4�,s- G. � <br />State2ip Plione <br />Stale/Zip Phone <br />� , � ('� l �.I� � -\ <br />EleClrical Conhaclor M11ail Address Gty Stale/Zip Phone <br />Stalo License Number <br />Proposed Use of Building <br />Contract Price of Work <br />Conlact Person (Plan Rovicw) <br />Descriplion o( Work lo Bc Done: � � P V' � Q{; {�n F �"(V1/I � Q � ��n � il� � C� �L ��) �� <br />NOT[: WIRING IN NON-DVVELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certil}� fhal 1 havc• read and examined this applicalion and knou� fhe sdrne to be hue and [ iJ�j U�j - �� 2 <br />conec(. All provisions o/i.iws anAordinances govermng fhis fype ol �ro�k �vill be cornpleted <br />rvhethe� specilied herein c� noL The g� �nling ol a pernuf does nof rosume fo givc aufhonty fo <br />viol,rte or cancol the prorisions uI any ofher slate or local la�v mguPfing consVuctien or fhe <br />perlormanr.e o/ cunsfn�cfion. Tha( 1 am �uthorized by fhe o�vner of this propert}� fo pedorm the <br />work /or �t�hich applic,vtiun is made and I compl�� u�ith the Sfafe Contractors Lan� i8.27 RCW and <br />2JG.200 11�AC. <br />1 . _ <br />