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ELECTRICAL PERMIT APPLICAT�ON <br /> CiTY OF EVERETT PERMIT S�RVICES <br /> 3200 CEDAR STREET, EVERETT, , :A 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATfQNS ARE ACCEPTED FROM 8 AM TG 4 PM <br /> 1�-�`i ll�• - �� � <br /> i r, - l>- -� c-, . <br /> PROJECT ADDRESS <br /> �C:��.,: l,�-�'-�rti'��-� Ao`�l� - l"0� i�s-. ;.E. tV-�.:�t� � �Z�S���f: 4�4D1- <br /> Owner Mail Address City State/ZiD Phone <br /> Tenard Mail Address l'ity Slate/Zip Phone <br /> f�14� �CICG j�l� �Cr� >f= ;.0 . �,�,�;�,Lc.�-ti.�S � -�� � �' <br /> � � � "�c. �r � � �� �Z� ��� z_�v <br /> Eleclrical Contraclor Mail Address ;,ily State2ip Phone <br /> c��' <br /> �\k\i_iC�iL-'��uj' ;�)C? / <br /> State License Number CoNract Price o(Work <br /> � -� . �. . <br /> Proposed Use of Building Contact Person fPi=r.Review) <br /> Cescription of Work to Be Done: � �� / L("� /�`'`^ �-� ttit \�-��n �, ( �L��� <br /> NOTE: bVIRING IN tJON-DWELLINGS IS REQUIRED TO FEE <br /> f3E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX COD[IS 3105 <br /> I hereby certily that!have read and exarnined this application and kno�v the same fo bo true and <br /> correc7. All provisions oflaws and ordinances govemmg fh�s type oI�vork will be completed <br /> whefher spealied herein or noL The graniin�o!a perrnd does no; resume to c�ive authonty fo <br /> vrolate or cance/the provisions ol any olhar sfate or loc I law reguPting construction or the <br /> pe�formance oIcpnstruc6on. That I am authoriz d by ie onvier oI thu prope�iy to perform fhe <br /> work lor�vfiich abplication is.viade ar�LlcornpJ�vifh t a Sfate ConUactors Law 18.27 RCW and <br /> 2962nG WA� '� �� � � <br /> � � � � � � -- �� <br /> '_� ����� -r" <br /> �� �<—/ � <br /> � Signature � --- Date -� � � ��� <br /> / <br />