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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 - DcB1T 8 CREDIT CARDS ARE NOT ACCEPTED <br /> i��. 3 /r�' D ' �' !'L S � <br /> PROJECT ADDRESS <br /> > /l�� r-' /o � s -/4 `� �� S ; 2n( <br /> ,!'� lC'��L/f=� S F ,5 �.,'JNOhIS/l I,�IA `76'Z9E 6/Z - �l> 1 <br /> Owner Mail Address Ciry SlateQip Phone <br /> �,�/!- C. i 1 n,� T <br /> T�nan� Meil AdArass City State2ip Phone <br /> Suo l-/)c �' 3[� G <br /> �� t S l��"i�r/l'��• f�N�ti� s �� ��^n.�oc�r� `r,�Z 7 z �yv- �3 o c <br /> Eleclrical Contraclor Ma�l Adtlress City Stale2ip Phone <br /> �)— � � !Y L 1- C_� [ i � � � ��F—/�� p -- <br /> State License Number Contract Price o� Wo�. <br /> C n /�nc-_� � , .a � o j rP/��'Et� <br /> ProposeC Use of Bullding Contacl Person (Plan Review) <br /> oescriptian a�Wark m Be Oane: l/�/I N 6 � (��.�T f�J/ //C�C � �'/�fI% P(J/'//� <br /> �/U�� I� /�� /%j] ti'UL, G��� �G' L� NEC�� " F�� C. C�1���(:��c - <br /> iil�' "I <br /> L E. � L�- k. [. c' c_ ,— c✓/G1 i /i/c� <br /> NOTE WIRING W NON•DWELLINGS IS REOUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 7705 <br /> 1 herebvi ce�Ph�that I hH��e reao ann eaannneu llus npptrcaf�nn ann know the s�me fo be true ard <br /> r.orrec( All pir,vrsrons ol laws and on7inances govem�n�tnis type ol wo�ti will be completed <br /> whr.ther sue�r:fiec�nerein oi neL T'he granhng o�a permrt dces �iot presume fo give authonty to <br /> i �riNafe or cancel fhe pruwsions o/env other slafe or rocal lew repulefmg consfruction or the <br /> Iperfo�mance a/eonstruction Thet I am aufhonzed by the owner ol this property fo peAerm the <br /> wor:c lor wlvch appdcafion�s made an0�romUiy with:Ire State Contracfors Law �fl 27 RCW end �1 i <br /> 296.200 WAC. <br /> � � <br /> , ,�� �/_ ._,..,� ,_,�,� //- Z - �� 7 C! ��� I <br /> ag„awrP �—� Date I <br /> �---- ----- -- —' II <br />