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ELECTRICQ►L PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 ���" �' � 7 <br />425-257-8810 - FP.X 425-257-8857 — www.everettwa.org � p7 � 6_i �6 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� �� ( i � --�� <br />4 '1� � � , -� � <br />PROJECT ADDRESS <br />L{, t�Ja <br />�Wf1Cf <br />+�L.Yi l.�t..�f `1J��'''� <br />Mall Address <br />Cily <br />� .,,�74, i�i <br />.��. �li�/�Z <br />� State2ip <br />Phone <br />Tenanl A9ail Address City Stale/Zip Phone <br />� � L .�.�i � <br />� G i ��"s 3 <br />L� !���_�� ��._�c�� "?c�.���,xs<<� �'�,fti,�t ���t�; ���� ���zs�z <br />EleClrical Contraclor Mail Address Cily Slalc/Zip Phone <br />�_(� I Z c' �'� f i i 21 ���� <br />Stale License IJumber <br />i `'f-�71� r%i,�.,c <br />Proposed Use of 5uildinc� <br />7 � . <br />Description of Work fo De Dona �``� `� 'n ��� ���� r- L �: ���'. 3 <br />NOTE.: WIRING IN IJCTN•D\V6LLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, AqC OR AC CABLE. <br />CI7Y OF EVEr2ETT LOCAL SALES TAX CODE I5 3105 <br />�L�c,v <br />Contract Price of 14brk <br />Conlacl Person (Plan Review� <br />� <br />� '7i/1�_- �I� <br />I hemby certi!}� Ihat I Oa��e read and ea�amined this application and kno�+� the same fe be fn�e and <br />conect All provisions o�laws and erdinances goventing ihis fypo olwork wilf be complefed <br />nliether specdied herein or noL The granfing o/ a pa>nnd does not presume to give aulhonty fo <br />violafe or cancel thi� provisions ol any other stafe or!ocal law regulating consfruclion or fhe <br />peAomiance o/ conslrucfion. That 1 am nufhorized � i the o�rner o/ flus property fo pedomi the <br />work !or which applicalion is made and I comply with the State Confiactors La�+� 18.27 RCW and <br />296.200 WAC. . i <br />i 1 <br />, (- .! ' ' <br />FEE <br />