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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - OE81T 8 CREDfT CARDS ARE NOT ACCEPTED <br />� , .� <br />, , � . �� S � , <br />C, � '�—C I C � � � � 1 <br />PROJECT ADURESS <br />LJ, <br />Owner <br />Tenent <br />„ �,� ic, s•.:� <br />Mail Address <br />Mail A�tlrese <br />t=��.��r <br />Ciry SutelLp <br />Ciry S1ate21p <br />Phone <br />Phone <br />L{2, -iji <br />��ilC�\Cr'��:��..GLl�iC:-i.0 ��L` �.�'�. � 17 �f1C1\t..�ll`�'�. �������� 77b`t_ <br />EleCtdGal COnlfaCtOr Mail AAdroaa Clly Slate/Zlp Phooe <br />��� c; 1�[� L- i I l �� ('-- <br />Siste License Number <br />(d . <br />.,_ [ ,_.'. r <br />, <br />Propased Use of Buildiny <br />ConVact P�Sce ol Work <br />Contact Person (Plan Review) <br />Descdption of Work to Be Done: f— �- (' i l( ; d 4 L �.-' r, �._ ��\., .— �!�.� _ ��t— _ <br />,:. � ( �� <' � <br />NOTE: WIkING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />I hemGy certrly !hef 1 heve res0 ana oxammed t/us applicefinn and know fhe seme fo be true and <br />corrBct. A!1 provrsions o! laws end ordinences govemmg this type ol work wdl be completed <br />whefher specr(eA hem�n or not. 7he granfing ol a pennd does not prasume ro grve authonty fo <br />violnte or cnncel the provlsions ol any other stafe or!ocal /ew regulefmg construction or the <br />peAormance ol conslrucfion. 7hat I em aufhonzad by the owner ol this property to peAorm fhe <br />wnrk loi which application is mede end 1 comply wdh the State Confrecfors Lew 18.27 RCW and <br />296 2U0 WAC. <br />� . <br />Siynalure <br />L <br />� � � <br />,� - . <br />FEE <br />� � � - <br />i, � <br />.�� ,���'��� <br />