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ELECTRICAL PERMIT �PPLICATION <br /> CITY OF EVERETT PERiVIIT SERVICES <br /> 3200 CEDAR STREET, EVEftEiT, VVA 98201 <br /> 525-257-8810 - FAX 425-257-d857—www.everettwa.org '� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> C � �� � � i l� <br /> PROJECT ADDRESS <br /> P, � fi �-� c�.�.��( <br /> Owne�' Mail Address Cily Stale/Zip Phone <br /> � <br /> � Tenanl �dail Address Cit <br /> I Y Stale/Zip Phone <br /> � � / r - r �/Z> ' <br /> C/t'� (� � ' ZOJ <br /> _r YI � 7 Z �-r C��C � �rt�,t l� ' -Yc�[(5 ��..� . �'2S Z 3.3> ?7 's <br /> Elec ical i.onlraClof Mail hddress ��h� State/Zip Phone <br /> �)L �'1-i��%l.= L.i5 I i�� f-( <br /> Stale License Number Conlrect Price of Work <br /> Proposed Use of Buildiny Contacl Person (Plan Review) <br /> Descriplion ot Work to Be Done: f-wjF ��j L�J y��r� (�o�'J/� �j�-rV-1 LE--' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily thaf 1 have read and examined this application and kno�v fhe same to be frue and <br /> correcL A!1 provisions ollaws and ordinances govenung this type o/work will be completed <br /> whether specified herein or noL The grantinc�of a permd does nof resume fo give aufhority to <br /> vio/ate or cancel the provisions ol any other stafe or loca!law reouPting construchon or the <br /> work for Nli/ch a�pl cation�'s n a'de and�l co�mplye�'fh fhe State Co/fractorspLe�v 18.27 RCrlh�and <br /> 296.200 WAC. �—� <br /> . ' , .,,��� ��� zv -c� <br /> ".(:_��.G.i . �� �. <br /> Signature Date <br /> ���s� f Z-�;�l � <br />