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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.�rg 6�..� b —�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �O O ` �a <br /> � lr�s � �,".., 1` ^ <br /> PROJECT AGDRESS <br /> � C �I �lM ��f�n� ��'/�I � �� �7a C � <br /> Own�r 1.1ai1 Addre Cily Stale2ip Phone <br /> Tenanl M11ail Address City Slate/Zip Phone <br /> n-��x/c f(<c�l'�?<� �U`(11 9 � f�f` �-,�r'l�rit�� �A 9s"Zf�- �U�Z�f-(Efl <br /> [Icctrical Conlraclor �dzil Addmss City StatM2ip Phone <br /> r,�H-avcl y,� z C�6 Z �« �� <br /> Slale License Number Contract Price o�Work <br /> Proposed Use of Duilding Conlad Person (Plan Review) <br /> DescriplionofWorkto�eDone: �1-j,�'��_ C� C�. F-���� ��f���� �G �u/� "Ji7"1 C'�-�'� 1\ <br /> � Z G �.,.,� �.��l�C�fC�,�7 r <br /> ./ <br /> NOTE: WIRING IN NON-D�N[LLINGS IS REOUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CA6L[. <br /> i <br /> CITV OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I he�eby cenily that!have read anAexamined lhis application and know Ihe same to be t/ue and <br /> corrccL All pravisions ollmvs anAordinances governing this fype ol work will be cornpleted <br /> whether specilied herein or not The granfin�el a pemut does not resume to give aufhority fo <br /> vio/ale or cance!the provisions ol any olher sfate orlocal la�v rec�uPfing construcfion or Ine <br /> pedormance oI consfruction. Thaf I am autho�ized by Ihe awner ol this property to periorrn fhe <br /> work lor which application is made and 1 compty with(he State CenVactors Law 18.27 RCbV and <br /> 296.200 WAC. <br /> �i� � � <br /> � Signature Oate • , <br /> . �7 i <br /> � -�G � <br /> �� � .? <br /> C, '�� i � <br />