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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 4 PM <br /> �C' .a l✓ c'/1 _Sin.C, /� l) <br /> PROJECT ADDRESS <br /> Owner 61ai1 Address City Slalo/Zlp Phone <br /> Tenant MailAddress Cily SWIe2ip Phono <br /> ' r Nr.l.t E�L4:_�_r,^�t��'.�11.4 `�('' /?✓E M� L l� ff�� i✓� y 8�5"� yZ S 3 S 5' IG�o <br /> Electdcal Contractor Mail AAdrnss Cily Slatailip PhonP <br /> Vr�'M�tl97RMG 00 _ <br /> Stata License Number Contracl Price o1 Work <br /> /�/4 <br /> P�oposed Use ol�uilding Contacl Person (Plan Revlew) <br /> / � <br /> Descrip�ion o�Work to �c Dono� /�r �� � /��u"d L/41i'�b � /u " (�ON ItG c�' eyi Sf��,�_ <br /> wiKS <br /> NOT[ WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAl(CODE IS 3105 <br /> I horeby certi/y fhnf 1 ha��e iead nnAn,xomined this�pplicafion and tinnw tho same fo 6e frue and <br /> correcf. All piovisions ollaws nnd ordinances pnverning fhis fype o/Hro�k will be complefed <br /> whother speaGeA herein or not The granfinr�ol e pennif does not resumo to givo authonty fo <br /> violnfe or cancel fhe`�rovis�ons ol eny ofher state or locnl lew reguPfing consfruction or fhe <br /> pei'�rniance o/construction. Thnf 1 ant euthonzed by fhe owner ol fhis property to poAorm fha <br /> wo�k !or whir.h epp�c�fion is made mid 1 compl}�wifh the Slate ConVnctors Lnw f8.27 RCW and <br /> 29C 200 11'AC. , <br /> � <br /> ` '�- C ��,,,�" ,�-;c-rL• <br /> � _ , r <br /> Siynalwe [7ate <br /> �c�>2 5J <br />