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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 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �'J� �,��-{�M�rP dtt.p � ��yNpus �a �� <br /> PROJECT ADDRESS <br /> Ev¢1��� (�a nn M• �a j <br /> OWner Mail Address City State/Zip Phone <br /> Tenan� Mail Address Cily State2ip Phone <br /> � EI er�-�� P.o, l�x 79GU r��(� Ua�(� W/-� �3� <br /> EleclriC31 ConlraCfor Mail Address Cily tate2ip hone <br /> YZ$-Ki3� y78 <br /> TR �LE.Z � 022C2.�_ � Z,aGo � <br /> State License Number Contract Price of Work <br /> Proposed Use of Buildinc� Conlacl Person (Plan Review) <br /> Description of W ork lo Oe Done: �1 SiA/ O� f U�/U C.7 F� QU�"/fL�- F�� <br /> G !1e w nu�no� l'� �c��'sr G� _ 'f"� �Lr� ovYi �— <br /> QG C� I ��I��s ���. <br /> -. <br /> INOTE: WIRING IN IJON-DWELLINGS IS REQUIRED TO FEE <br /> � BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT L(`CAL SALES TAX CODE IS 3105 <br /> 1 hereby cerfily fhat 1 have mad and examined fhis app/icalion ond know the same to be frue and <br /> correct. All prorisions o/faivs and o�dinances geveming Ihis type o!work will be complefed <br /> whefher specdied herein or noL The granting ol a pemut does nof resume fo give aufhonty fo <br /> violale or cancel lhe provisions ol any ofher slafe nr local law reguPtinq constructwn or the ^ <br /> peAomiance o!construc6on. Thal 1 am aiRho�ized by Iha owner ol fhis property fo peAonn fhe I I <br /> work/or�vhich application is made and f comply�vith the Stale Conhacfors La�v 78.27 RCW and <br /> 296200 WAC. (, � <br /> ( ,�(v <br /> � � I� U� <br /> Signature Date I�/ <br /> L <br /> J <br />