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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �.zZ-o� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org l,�0 7 0/—� �-�j <br /> APPLICATIONS ARE ACCEPTED FR�AA 8 AM TO 4 PM <br /> 1� �-�� U `>.� ; ,-� � ,, S C <br /> PROJECT ADDRESS <br /> "1� c <br /> Il r"I �,.. � O,r�� oo- '� � ��'� aC1 .� � ���� �� � C L.Uc.��,�i; C1�0�� <br /> Owner M1tail Address City Stale/Zip Phone <br /> Tenant Mail Address Cily State/Zip Phone <br /> ��i� � � h ��t� � -��niC �U �CII� �.c�Cv�l �(.4-� �1�r7n�.J.•��1 VL�(. �i��.lb <br /> Eleclricai COnlraclor Mail Address City Slate/Zip Phone <br /> �-- <br /> ����� �N � 'L?�'; IC,`� <br /> Stale License Numbcr Contract Price of Work <br /> � � �� <br /> Propose�Use of Building Conlact Person (Plan Review) <br /> Descriptien o(Work l0 6e Done: ��( � �� .,,� c,-., I`�- rn�i o�e �� �'�G C c'.'�r� SG V i;, c � _ <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here,by certi(y fhat 1 have read and exarnined this application and know the same to be We and <br /> coaect. All p�ovisions o//aws and ordinances govermng this fype of�vork will be comp/eted <br /> whether speci6ed herein or nol. The granting o(a pemnl does not presume fo give aufhonty t� <br /> viola(e or ca�cel the provisions ol any other state or local law regu/ating construction or fhe <br /> peAormance o/construcl�on. That 1 arn authorired by�he a ner o(this property to pedorm fhe <br /> u�o�k Ior which application is made and/comply�vith the Sfate Contractors Law 18.27 RCW and <br /> 296.200 lNA C. <br /> 1' <br /> �, ����\`�, 1 7 C— <br /> SignaWre � Date <br /> Eo.�oi -�Z� <br />