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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �j — I '-/`� `� <br /> 425-?57-8810 - FAX 425-257-8857 —www.everettwa.org C-o 7 D 3�76 I <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �'l� S 5 C�� /�I �. 1ti-+ . S� _ <br /> PROJECT ADDRESS <br /> �'e f�rL� �- � 7�� p c`� � S7�., r <br /> Owne� Mail Address City State/Zip Phone <br /> �/1 f��'1 C.'1/v�J�� <br /> Tenant Mail.4ddress Ciry State/Zip Phone <br /> ���ici7� A�-1✓iCr,n vic%cd l�i ZZe (; 2"�'fiv� �(/K tAl�(���iv� 1n/4 . `1 �2z-3 <br /> Electrical CoNrector Mail Address Cily Sfale2ip Phe�e <br /> //..;�'„���V "I 71 ��.r� �/5 UU <br /> utate License Number Contract Price of Work <br /> v�11C� � <br /> � w, K <br /> Froposed Use of Bui�ding Conlacl Person (Plan Review) <br /> Descriplion of Work lo Be Done: f � '�C �%t [G:rl'n <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceRily fhat 1 have read and examined this application and know the same to 6e true and � �� L 3�1� <br /> correct. All provisions o/laws and ordinances governmg this type ol work will6e completed <br /> whethcr spea6ed heroin or noL The granling o/a pennrt does not presume to give au�:icnty fo <br /> viola(e or cancel the provisions olany other stafe or local law regula(ing construction or the <br /> perlormance o(construction. That 1 am aulhorized by fhe owner ol(h�s property to perform the <br /> work lor�vhich applicalion is n�ade and 1 comply wi(h the Stafe Confractors Law 18.27 RCW and <br /> 296100 WAC. <br /> � f� <br /> _ L,�� . �� �`r �� I`���' � <br /> Signature� Date <br />