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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT', WA�J8201 <br /> 425-257-8810 - FAX 425-257-8857—www.evefetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> � d o o � ��iz �r� .���.�� re�� ��d���9 <br /> pROJECT ADDRESS <br /> ,� 12� �Gl� �n � 5U1 W� ��'��� � o <br /> Owner <br /> MaftAd City State2ip Phone <br /> Tenant �� Mail Address City Stste2ip Phone <br /> l S� u� e� %r ��'�y�jar �f� I H� Ul�l ��D22 �b� S�L���b <br /> EleCtricel ConheGtor Mail Address Clry SlalelZip Pbone <br /> �eGlee�Q L� �, b� <br /> State icense Number ConUad Price of Work <br /> ' h 'ff l � S (i{'1oV1 11'1G�V1 l . x� <br /> Pro o d Use of Buil g Contact Person (Pla eview) <br /> Desalplion of Work l0 8e Oone: �"" ��� <br /> NOTE: WIRING IN NON•DWELLINGS 15 REQUIRED t0 FEE I <br /> BE IN RACEWAYS, MC OR AC CABLE. �O(� I <br /> CITY OF EVERET7'LOCAL SALES TAX CODE IS 3105 ' <br /> 1 hereby cerfrly thaf I have read and exemined this application and know the seme to be hue ond C�-7� ( _�05 <br /> corr�c[ AIlprovisions oflaws andordinances goveming fhis type olwork wiU be canplered C G���•-� <br /> whether speciiied herein ornot. The grenting ol a permd does not�resume io give euthonty fo <br /> vlolate or cancel the provisions of eny other state or local law regulahng conshucfion or the <br /> per{ormence ol construotion. 7hat 1 am authorized by fhe owner of Mrs property to peAorm the <br /> �wrk for which epplica in made and I cornply with the State Conhectors Law 1927 RCW end <br /> 2 00 WAC. <br /> ! I'v <br /> , <br /> Signeture D e <br />