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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 3 ` 4 `' 3 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org ,��3 p � -i�r <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> i ' � <br /> 1 � ? ti ✓ V <br /> ; ; ) � f ��J %�i..� ,� �� <br /> PROJECTADDRESS <br /> , � , . <br /> J'��; a�<� �� rv'c. ��3� �.,-�,,.� ;;i� .� � � ���<��� �����' ` <br /> Owner � MailAddress �ily Slate/Lp Pr�one <br /> �, �. . ..y .. <br /> f"�'( 'U'� ��tLll/, , , , <br /> Tenan� MailAddress City Slalc2ip _ � �; , Phone <br /> »� ��-� ��G' � I��=' �; <br /> � � i il � ���,,���t �l�,r ) ! %L)�� ! �(�- ✓':Tf;i�,-.,�. r:G,' C �i(7� [_ii` %��� "["l:) <br /> E�ectnca�Cdntraclor �ail Address Cily Stale/Zip Phone <br /> -' ,�k'� -3 ��/J'l/=-- <br /> � , �1���19�, � �- <br /> Staie Licens Numbe Conlracl Price of Worie <br /> � � / ,/ <br /> /i ll,;,'i�!' / .�`� `1, / i. .1/ <br /> i�' r'�91 �1�i% r ,, ;, _ <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> � , . <br /> Descriplion of Work to 8e Done: ' %"� ' �'' � � � <br /> _ ', , <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> l7� • n � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hemby ceAily thaf I have read and examined this application and know the same to be frue and i � ��i �— t j Cj <br /> correcL All provisons ollaws and ordinances govemmg this lype o)work will be complefed ' <br /> whefher specilied herein orncL The granfing ola permrt does not presume to give authonty to <br /> violafe or cancel fhe prowsions o/any ofher stale or local law regulating construcfion or fhe <br /> peAormance o/cons WcLon. Thal I am authonzed 6y the owner ol this property to peAorm the <br /> work lor�vhich app6cafion is made and I comply wifh the Stafe Con(ractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> i���'�j �_. ���Z��� <br /> Sigrature ' Dal? <br />