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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.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />_ . . � I i ;. 5 .. <br />PROJECT ADDRESS `� <br />y_��-o� <br />L D�O�i`" �O� <br />, �� � .:�1 ys <br />��,� iiI `/c���f /5�� ;�/�r %'��� ��„ r.���' k%; �.�.5' Y�' <br />Ownr.r hlail Addmss Cily Slate/Lp Phonc <br />Tenant <br />Mail Address <br />Gly <br />SlaterZip <br />Phone <br />i.?.s�r „�,�� �s� i=�r.tiTl ct-� `i5;��1 355-�s'y� <br />El�r.trical Coniraclor Mail AAdress Cily Slate2ip Phone <br />1) `� ✓ 1 L � -+�' � .C� (S' J <br />Stalo lice ise Number <br />,y.�� ; � <br />Proposed Use ol Buil ]ing <br />Description o( Worh to �e Done: ��- i��� <<.' [- �� `� <br />NOTF WIRING IN NON-DWELLINGS IS REQUIRED i0 <br />B[ IN RACEWAYS. MC OR NC CAE3LE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />'� �.-c� <br />ConL•acl Pricc ol Work <br />Contact Person (Plan Roview) <br />! hen�by crrtdp fh�f 1 haw ro�iJ nnd rrannnrJ Ihis applrca6on and kno�v fhe sarne to be fnm and <br />conrrt All pio���sinns allmrs �md nrdnionrns ���crrninp thfs fype ol �sarM �rill bn complefed <br />whefhr.i spc�died heroin c� nuL The c7ran6ng o( �a pernuf does nof prnsumc to r��ve nufhonty fo <br />�vol�fe or cnncel Ihc `��ov�sions ol any ofher sfalr, or loc�l lais mg�dafm� constiuc6on o� fhe <br />peiforrnance ol conslnichon Thnt 1 anr aulho�i.-ed by fhe rnvner o/ flus properiy� to perlomi thn <br />work for which app6r.efion is made and 1 wntply wifh fhe Stafe Confracfors La�i- 18.27 RCW and <br />29G.200 WAC. <br />� <br />�_ �< < . _ <'y,� <br />" _� <br />s��in,i�uie <br />_ �/-�G—C� % <br />— Date <br />FEE <br />i <br />/ <br />� �l � <br />�� ���� ���. <br />