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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � � �c�_o� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 C �S �J <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org �g07" � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ���� � Ue �it�✓�- �l V� <br /> PROJECT ADDRESS <br /> ,� -r ti-Yr�"�—i L✓�% / J�/c. � <br /> /��„��-�-� � �a � ��fM, C � <br /> Owner A1ail Addwss Gty <br /> State2ip Phonc <br /> S � � fi j�f�c .� �? � w� f ,� r�t.�-r� iti,� >�� �/ <br /> e t�cv , <br /> State/Zip Phonc <br /> Tenanl Maii Address City <br /> . `7 <br /> Sri , � -f /.�� h �_ , G /�-�.�.�f,., �,/f? ��.�,23 1` � yi <br /> CG1 ✓/ % A'.�Y. ) I� � <br /> Eleclrical Co�lractor Mail Address city <br /> State/Zip Phone <br /> �—> t... <br /> � U�" � ' C i� /'�! ,� � GC,c� <br /> Statc License umbcr <br /> Coniract Price ol Work <br /> Pro o �d Use o(�uildiny Conlac�Person (Plan Review) <br /> Description ot Work lo�e Done: � � ��'�LG�ti� �r" / ''r'"=y"�' � `�/� f I o-7`",`�L�-�� `�n`rc� /��'�c <br /> C��f`I � Z� Cc��� � � )�7 77� S-t'✓ri P✓ /�crv7+-� cctlt�d�% 5/7i <br /> � i . <br /> � n. , G �i�,'� - �'%✓ /✓�✓�.c.� , <br /> NOTE: W IRING IN NON-DW ELLINGS IS REQUIR[D TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> 1 herrby ceiti(y fhaf I have read and examined fhis ap�lic�lion and kno�r the sarne to be Vue and <br /> conecL All provisions o/lan•s and ordinances governmg fhis type o/�rorh u�ill he cornplefed <br /> ❑Irether specilied herein or not Thc grantin9 0/a perrnrt does not preswne fo 7ive aufhonfy to <br /> violale or cnncel fhe provisions o(any other state or local law r�gulafin�conslro,.'ron or the <br /> perlorrnance o/consfrucfion. Thaf 1 arn authorized by fhe o�vner o/fhis propnrty(o pedorm Ihe <br /> �vork Ior�rhich applicafion is maAe and 1 comply�silh Ihe Sfafe Conh�actors Lau� 18.27 RCW and <br /> 296200 Lh'AC. <br /> � ZC � i� '� � �� Y— G �Y <br /> � Sic�n�lurc Date <br /> � G�Cc�l-- I S`( <br />