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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 3 p _ o � <br /> 3200 CEDAR STREET, EVERETf, WA 98201 � ` / <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org � Q g07,��6 E� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 pM <br /> /C�5�. � �% � ��. 5i_: <br /> /-�,.o :� ���/`� `/y'r2� � <br /> PROJECT ADDRESS <br /> . � <br /> �U�tS t, � �o.4�t��„�.r�/ � ��;��� ,���� ?U �� �!�� � ���iz�>�� eil��� �-�' � 70 i <br /> Owner � Mail Address City Slate/Zip Phone <br /> Tenanl Mail Address Cily Stale/Zip Phone <br /> �oo,L�,����„f 6�„/, 30l 3° '� � ��j..,,., ltit7 ��0� � a-531172ziy <br /> Electrical ConUaclor Mail Address City S(atelZip Phone <br /> � ��-/ s c r - �� �-� ,� � ��I��q <br /> Slale License Number '� Conlract Price o(Work <br /> 7< N � �l�C / �i �y �4��/7 �k��� 3 __ <br /> Proposed Use o(Building Conlacl Person (Plan Review) <br /> i �- � <br /> Oescriplion of Work to Dc Done: ��""�'u °� '* �� C u.�-t� ''�4 S y5/ � �f�a — ��� U��l/o�� <br /> . • <br /> � l ��P <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> ��� � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereGy cerTily fhat 1 f�ove read and examined this application and kno�v fhe samo to be frue and <br /> correct. All provisions ofla�vs and ordinances goveirung thrs fype of work will be compfeted <br /> whether speafied herein or noL The�ranfin�oI a permit does not presume to uive authonty to <br /> violafe or cancel the provisions o(arq�ofher sfafe or local law regulafing constro�.fion or fhe <br /> periormance of construction. That 1 am aufhorized b}�the o�vner olthis property;o peifomi the <br /> work lor�vliic0 applicafion is made and 1 cornpl}��vrfh fhe State Confractors Law 18.27 RCW and <br /> 296 200 WAC. � <br /> i' t ' � <br /> � � i <br /> i, <br /> ; ,�, , �';,l�i 7�3° � � <br /> �—SI�naNre ' Dale' <br /> Ea&o�-�6 ,� <br />