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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 A PM <br /> i I� 7 I.�O `,' `_, 1 `� ... . ,-� ,(� a- <br /> PROJECT ADDRESS <br /> t- ` -� '' u ff (.Jh Si�JcFo <br /> .� �� �� :� 115 IOn S 1 �. 1� A1 L. �„ <br /> Owner � Mall Address Giy StaleiZlp Phone <br /> ��! �. � <br /> Tonant MaP AdOress City Slate/Zip Phone <br /> � C � � ` L. I.� I� �r G �7 �It.�4� ^ 1l��ne ��d� {y' S�: 'Cli�n c !�/! �Oi. J�f"L S ��S <br /> Electrical Conl ador Mail Address Cily Slale2ip Phone <br /> rl�i.�c�.t_t l��1 $`�(!(l D d <br /> Stale lic�:nse Number Coniracl Prico ol Work <br /> 1'� r c .�,� �� — <br /> Pro osed Use ol BuilAing Conlact Porson (Plan Rr,viaw) <br /> Descriptinn of Work to De Done: 1 �� ��.,\ � . . W i %c d :��� < < �o� � �.,:�. , c} _ <br /> _ t., e.e 1,.: n a �___ <br /> NOTE WIRING IN NON-DWELLINGS IS REQUIRED TG FEE <br /> BE IN RACEWAYS, MC OR AC CAliLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 h���eby uaLly fhaf I have icnd r�nd crFlrnured(7ns appliceBon end 6nou-fhe same fo be frue and <br /> ���urecf� All piuvisions o!laws end nrJinnnces ym�enun9 fhis fyp^ol work will b:!conr;�leted <br /> �5�hefhr� sper:ihed hemin oi nof TIIP�li"I11611(J OI POP/Ol(f does nof presunie lo ome n:dlronty fn <br /> vnilnfe or cancel lhe ?iovisrons o(eny olhei stafe or local law re�ulslmy con�buchon rn fhe <br /> �av(onnnnce u!�,�o�is�ruction Tllfll I N/Il F7111IIOIlTB1�by IIIB OLVIIPI OI IIIIS(110nB11'. �0(1B1101R7 IIIf <br /> ��-�nk fo� whir.h npp6cnhorr Is mndr errd I c omply�wrth Ihe Sfaf� ConfrEictors La�i id "t7 RCW end <br /> ?4ti 200 WA(' <br /> a / <br /> ;��rc Dal <br /> � � <br /> �- ��� �'� � —� � <br />