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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SER`✓ICES <br /> 3200 CEdAR STREET, EVERFTT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —vsnnN.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � � (�4- ( }�, ' '� � �v�r� i+ �/N� �b'�!1( <br /> PROJECT ADDRESS <br /> ����lr� r�..� 1�; �-.,r '� ��Q4' uf"�. S'� (- ,VP�P11 �nl�T `��`6)_l� gZ5 J4'� ' SL��j <br /> Owne� - P.1ail Address City Slate/Zip Phone <br /> Tenant MailAddress G!y Slate/Zip Phone <br /> �1� .,�uf.,f`r� C�r_.lv, I �,r 1'�'v Cl C���� �f��n'AI� oc U/h' �`F ) i.� jEl! �)7 ��JIL�+ <br />� Eleclrical Contraclor Mail Address � � City State!Zip Phone <br /> � �� (� � f �_ I `.�I �`t" C _ P � 7 r � �J \J <br /> Stale License Number ' Conlrect Price of Work <br /> -, �, •, i ��.tr.. '< <br /> Proposed Use of BuiWing Co�tacl Perscr (Plan Review) <br /> Description of Work lo Be Done: ��,„" �, i � : �„i �- �'n �i.,T ��ti ��� <br /> �JOTE: W IRING IN NON-D�NELLINGS IS REQUIRED TO FEE � <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereb}-catily lhat I fiave read and examined this applicafion and kno�v the sarne tu be true and �C�`�I 2, - I � I <br /> conecf. A!I piovisions o(la�vs and ordin,�nces govemmg Ihis type ol�Lork �vill Ge coriipleted <br /> �vhether specilied he�cin or noL The granting oI a pennd does nof �resurne fo give authority fo <br /> violafe or canccl fhe provis:ons o�an}�other sta(e or local law re�ulafing construc6on ur fhe <br /> petlorntance o/consfruct�on. That!am authorized by ti�e o�vner ol this property to perform thc <br /> work lor�vhich applicafien is made and 1 compty wifh the Sfate Conlraclors La�v 1827 RCW and <br /> I 29d200 l4�AC. <br /> ���' �..�� � � � ' �f / �1 `} <br /> � � Signalure Date <br />