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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—ww�v.everettwa.org <br /> APPLlCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,� I � Z 0 ��er �� ree,� W�, 5�, 1-� E � F <br /> PROJECT ADDRESS <br /> % COpIt� � /� c� � PI�c, �P fPl'✓lGP/' <br /> ��efAr�'y �r�Pe.f �iPs yZS-33q- 3�3`� <br /> OWner � Mail Address City SWte/Zip Phone <br /> � f v�� l�iF �vrn; ��tic. �OD - 44 177/1'�I�S �rJ-GLis. <br /> Tenant Mail Address City State2ip ��C� S�3P%3// <br /> � r`S C�FG l t I G <br /> P� �r�x 1 y� z �ia;�s�,/��' �J,� 5'�'z7o <br /> Electrical:ontraCtor Mail Address Cit Stale/Zip Fhone <br /> uJ <br /> �S E�_C ��c •� �z z a Z .� S I-s — <br /> Slate License N!imber Conlract Price of Work <br /> C'�e ��1� ( <br /> Proposed Use of Buildiny Conlact Person (Plan Review) <br /> Descdption of Work to Be Done: /y G`C� G �L(��' C��c v��l•t , Y�Q w��� <br /> c v r� e -(1 �� � ��� �i'i`S � �n ��r c., c� � �i c Pl. <br /> NOTE: Wi�ING IN NON-D�NELLINGS IS REQUIRED TO FEE �� <br /> BE IN RACEWAYS, MC OR AC CABLE. I,�� � <br /> 1 <br /> CITY OF EVERETT LOCRL SALES TAX CODE IS 3105 I <br /> 1 hereGy certify thaf 1 have revd end examined this application and know fhe same fo be true and <br /> curect. All provis�ons of laws and ordinances goveming this type of work will be completed <br /> whether speci(ed hereii, or not The granting of a ponnd does not presume to give authonty to <br /> violafe or cancel the Rrovisions o/any other state or(ocal law regulating construction or the __ <br /> performance�f construction. TF,at I 2m authorized 6y the owner ol this property to peNerm ihe _ � ' <br /> wo�k/or which spplication is madaerrd comply with the State Contrecfors Law 18.27 RCW and � � -, <br /> <"96.200 WAC. � � <br /> ^ � <br /> _�� > l��` �%�`ti�-- Z-(� - p <br /> Signature Date <br /> / �' � 5 <br /> ' L <br /> 1��f j - <br />