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ELEC�RICAL PERMIT APPLICATION <br /> CITY OF EVER�TT PERMIT S�R��ICES <br /> 3200 CEDAR STf�EET, EVERETT, WA 98201 <br /> 425-257-i3810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8,4M TO 4 PM <br /> �� /2�� �Yll�� �� <br /> PROJECT ADDRESS <br /> � �ll�1G� ����5 ��1,r�I ��� �Ul����l � �37; (���I6-22o� <br /> pwner Mnil Addrr.ss ciry S�atN7�p Phona <br /> Tenatl� Muil Addtess City SlalelZip Phone <br /> �fPl'ria✓l l�leQ��i� 31o��fl�L�.S'1` �nu��rlac� G�� �'�c22 �r� �s-3�y <br /> ElecUiCal ConhAdof Mnil AddresS City Slale/Zip Phone <br /> ��� T.��� � �-lLs �oD <br /> Slete LiCEnse Number Gontract nce of Work <br /> A <br /> . T�-IM '}� PO � 'L l,l ! 1� <br /> - .. l . � <br /> Proposed Use of 6uildmg � Contad PersOn (Plan Review) <br /> Square 1=ootape(If residenliel n5w ConstruCtiOn,remOdel or addition) <br /> DescripHon of Work to Bo Done: �'�--�' F I��� <br />\ <br /> — � 1 7 —� <br /> � <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. - - <br /> ��� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 37D5 <br /> 1 horebY certily thet 1 have reed and expmrned this application and know tha same to be true and <br /> conecL Ail provisions o/Inwc and vrdinances powmurp this typo of work wilf be,completed I <br /> whetho�spoa/reAheroin or not. The gronhr,p of a pArmR does not rosume to grve euthonry to <br /> violate or cance!fhe provlsions of anV other stafe or�ocal law reguPtMg ca�strvetlon or Iho <br /> peAormanco ol conslructi0n That I om authonzad 6y the ownar o1 this property t0 poRorm tho <br /> work for which applicati0n is m hd 1 compry wilh flie Sfato Contractors Low 18.27 RCW and <br /> 296.200 W / <br /> i <br /> %� <br /> ignature Dote <br />