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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRCET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM Tq 4 PM <br /> �`'� /�6 5J� /�fr�� '-�, F����;���v�- 1����� <br /> FROJECT ADDRESS <br /> ld v� ��r��� � 9/6 s��� f���zW.� �������� ���� 0� '�f�sa3��75 <br /> Owner Mail Address `� Ciry Stale/Zip Phone <br /> ���12(� <br /> Tenanl Mail Address Cily StalelZip Phone <br /> Y <br /> Ci CJ N�%� vfZ��2%_ _ <br /> Eleclrical ConUactor Mail Address Cily Stale/Zip Phone <br /> Slale License Number Contract Price of Work <br /> Proposed Use o(6uildiny Contact Person (Plan Review) <br /> Description of Work to Be Done: r,2^���� � ��'�NSg� Q �/ T <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABL.E. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ;/���� �l <br /> I he�e6y certily fnaf 1 have read and examined this application and knouv fhe sarne ro be true and li <br /> conecf. AIf provisions olla�vs and ordrnances govermng fhis type ol work will be completed <br /> whefher specdied herein or�wL The c�ranting c/a penn�t does not pvesume to give authonty to <br /> violate or cancel lhe piovisions oI any other state or local law regulating construcfion or the <br /> pe�lormance o(cons(rucfion. Tha(I arn aufhorized by the owner ol this property to perlorrn the <br /> work(or which applica(ion is rnade and I comply wilh ihe Stafe Conhaclors Law 18.27 RCW and <br /> 2P6.200 WAC. <br /> ._ __ � :� ��/ <br /> _, . - %��1�.,;= - .� o�' <br /> Sipi�oture �... v ' Dole <br /> i <br />