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ELECTRICAL PERMIT APPLICATION I <br /> CITY OF EVERETT PERMIT SER�iICES <br /> 3200 CEDAR STREET, EVERETT, V�+A 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> �f —3—� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C �C,��_�'J� <br /> � `:7 � <br /> I��� .���'i� n ��U�l �� V <br /> PROJECT ADDRESS <br /> //l_�'�`l l�u ,�-� � ���>s'�''�l S>- ,c�� {�lK«�,� ���z�f c�,� <br /> Owner MailAd�ss� City State/Zip phone <br /> 19i� I�e��Pu,.�� �7� <br /> j�� ��/ �2 �� ,� 'z �u�..�7� �.�-� <br /> Tenant MailAddress City State2ip phane <br /> �is �='��s r- �rz s-- �y:z - <br /> �l� i�i> � �n«/ ����Lu�Q � � R'.4c�3� /2 �� � <br /> Eledrical Conlractor M ilAddress Ciry State2ip Phone <br /> ���f i�� -�� �� /T!3 5�=' . �,r� <br /> State License Num6er Contract Pnce of Work <br /> �� l t.! t �_ ��� ��l N�14� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> � <br /> Descnption of Work to Be Done: �J�-� ��t't �-� C/ � =L L- � �'�1 1 k4�d� �-��'( «— <br /> S �q � <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> !hernby ceriily that!have read and examined this applicafion and kno�v the same to te fruo and <br /> conect All provisions o/laws and ordinances govemmg this type o/work will be complefed <br /> �vhether specified herein or not. The�ranting ot a Fermd does notp resume to give aufhontylo <br /> violate or cancel the provisions ol any ofher state or local law regulating construction er tha <br /> per�ormance ol construction. That 1 am authonzed by fhe owner o(this property to pe�form fhe <br /> �vork lor�ti�uch applicafion is made and 1 comply with the State Contractors Law 78.27 RCW and <br /> 296 20 AC. <br /> �,L�������'vv`'t 1�3� �c��. <br /> Signature Date <br /> . F�� � i �co� <br />