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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 /> APPLICATIOPIS ARE ACCEPTED FROM 8 AM TO 4 PM G�'�(f� <br /> � L�-O `��I--d� <br /> � � �. � �� r �,� '" � � - <br /> PROJECT ADDRESS <br /> m,� k�--1—�or,'� �.S 13- lZ-N,� �Ct-.l��.cN 3�S Ev��a� �t��.0 1 <br /> Owne� Mail Address City Sfate2ip Phone <br /> Tonanl Mail Address Ciry StatelZip Phone <br /> 5�,.�.---•���5� �.lac�'��� L�1��h �.-1 `�, Srol�.or..� s� �� �� 1 �i�S •33s '7 �Sy <br /> ElecUiCalConlractof Mai�Address City SWIe/Zip Pbone <br /> SNoHo�'I. l \o p � <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Descr�plion oi Work lo�e Done: �'���'-�• ���-v� �t-� � -�--��L-, �`�v S Q �-�� <br /> � <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACE\NAYS, MC OR AC CAdLE. <br /> �� 5 . 'a-�` <br /> CITY OF EVER[TT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi(y that 1 have read and examinrd�hrs,:apficah��and know the same to be We and ����� - U3 y <br /> crorrecL All provisions oll&ws and ordinances govemmg fhis typo ol work will be completed <br /> wfiether speafied herein or noL The granfing o(a permd does nof presume fo give authonty to <br /> vinlafe orcancel the provisions ol any other state orbcallaw regulating construcfion or the <br /> pedommnce o(censtrucfion. That I am authonzed by the owner ol lhis property to peAorm fhe <br /> work Ior which applicafion is made and 1 compty with fhe Sfate Confractors Law 78.27 RC W and <br /> 296.200 WAC. <br /> ���v(� q <br /> ��� �T`��Vv���L��`, l ��1 ' �o <br /> 5 nali�r � Date <br /> � � <br /> L <br />