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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERE:TT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� <br />�il 3Z^ ,�1- S��S�t��C � <br />PROJECTADDRESS <br />� —o �-os� <br />r'O�b2�D�j <br />J <br />�;L Fll�r � ��%9 I3Z����: t��,,�i� �tiv� yst�r <br />Ownef MalAOdress Gly SWInfZip Phone <br />�>> 5�� I,l�'711�� �S i S 1 3L �Sf S£ � vGi rf� �'i ��i' _ <br />TCn;ln� MadAddress Gty SlatolZip Phone <br />. <br />Eicctriwl <br />V�IL li��i�fl 4J./ <br />Slate Licenec Number <br />H' �� / / <br />Prbposed Use of 8wlding <br />Description of Work to Be Donc: <br />Mail Address <br />//(.( ��, b � <br />/` I <br />U l�GI Af" G':.� �!!S� /C4/STf� <br />NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO <br />BE IN RACEINAYS. MC OR AC CABLE. <br />CITY OF EVERETT LOCAL S:.LES TAX COOE IS 3105 <br />City <br />_ I�►� 5'F�T <br />State2ip <br />� .� S�o `� <br />Conlract Price of Work <br />�lr" yG� � <br />Contact Person (Plan Rev�ew) <br />1 here6y cartJy thaf 1 have �aad and exammed this applica6on and know. the same to be frue ar.d <br />cerrecf All provisrons ol lan - and ordir;ances governrng fhis type ol work wAI be wr. plofetl <br />whethcr cpeci6ed herein or not. The granhng ol a p^rmrt docs not presume to qive aufhonry to <br />v�olafe or cancel lhe provis �ns ol any ofher state or local law rrgu(ating consf�uc6on or fhe <br />oerformance o! constmctioa ihaf / am aufhonzed by fho owner ol this p�operty fc peAorm the <br />u��^k !o� whrch apphcadon is made and I cemp!y wRh fhe S(ate Contractors La�s 7& 27 RCV✓ and <br />� <br />2 / �/G� <br />� 1; % '!/ <br />rEE <br />1-a3�c_1 u�S <br />Phone <br />