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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ��}�.�(� <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> �'o6mi�� 5 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �.���=t��;(�� l�����-ii� ���,.� <br /> PROJEC7 ADDRESS <br /> . '%�'b,?c.. <br /> r���✓"�i���� � C�r�.7i)c I �_,-��i(,� /S���tic,��,/(/c-J t/_�ce,� l-.�/� %Y�cr� �`'��� <br /> Owner Mail Address City Stale2ip Phone <br /> Tenanl Mail Address City State/Zip Phone <br /> � Jj <br /> ���� C /r -< fi' i� �'i�i 7C'`_ ��i�- � � �10`10 Yr �/, �.J /� I YJ�/I �'77- �3� �— <br /> Elecirical Conlractor Mail Address Cily Slate/Zip Phone <br /> �/'�� .'1 [ �L C lli�LJ /�'/� /�'�G7. C(i <br /> Slale License Number Contrect Pric�of Work <br /> �� C �/Crc /��� �— <br /> Proposed Use o(E3uildinc� Contact Person (Plan Review) <br /> Description o(Work lo �e Done: /��r��i , '��� �/, r�(� �'i i c v i I /C�.� <br /> ��c�i t�C� /��' � C��c��(-� <br /> � _ <br /> NOTE: 'dVIRING 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 thal 1 have read and examined this applicalion and kno�v the sart�e to be frue and <br /> correcL All provisions olla�rs and orclinances governm,q fhis type o(work will be cornpleted <br /> whether speci6ed herein or noL The g�anfinc�o/a pernuf does not presume to give aufhordy to <br /> violafe or cancel fhe�rovisions o�any other state or localla�v regulafing cons(rucfion or Ihe <br /> pedomiance olcons(rucliar. T,hat I am aufhonzed by the owner o/fhrs property te perlomi the <br /> work/ar which applicalion is made and 1 compl}��vi(h fhe Sfa!e Cor.trac(ors La�v 18.2i P.CW and <br /> 296.200 WAC. <br /> _ / <br /> � �'; . _ __ �=r�� -U� , I ��� <br /> Signalure , Oate �,1 <br /> ,`�J <br />