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ELECTRICAL PERMIT APPLICATION <br /> CITY GF 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 <br /> � ���'� �`'3`� <br /> ��r - <br /> ��(i I�iiCX,�l4�'Cit J1VC �'�LI . Cl ,( J('� <br /> PROJE�TADDRESS '� <br /> NC,�C DU���<, + ��r r1�E�i/'ii_ i�! Gvc,�ejl �,U�� :;,a5 ��rc �sti 7 <br /> Owner hlail Address City SlatelZip Phone <br /> Tenanl Mail Addrnss Cily State2ip Phone <br /> L�1 ��(�1�L i/ <br /> Eleclrical Conlraclor Mail Address Ciry Siale2ip Phone <br /> Slate License Nmnber Contract Price o(Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work lo Be Done: � �rYLO V110YQ ��• f v i�� pC1.nc� <br /> �( .4 /1r ` CU F-lVIIKic ��D�c'y�' ._. ��u00 5r (,,.r b,�-�. Ir✓c�IS <br /> NOTE: WIRING IN NON-DWEILINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y certily fhat 1 have read and examined fhis applicafion and know fhe same to be true and <br /> correct All provisions o(laws and ordinances govemmg this type o/�vork�vill be completed <br /> whefher specilied hemin or noL The granling oI a pemuf does nof �resume to give authority fo <br /> violateorcancelthe provisionso/anyotherstateorlocallawregul.3finc�construcfionorthe <br /> perfomiance o/conslnmfion. Thaf 1 am aufhorized by Ihe ou�ncro!Ihis property to perfnnn fhe <br /> �vo�k lor which application is made and I wmpty wifh fhe Sta(e ConLactors La�v 18.27 RCIN and <br /> 29ti.200 WAC. <br /> � �c"��%lli! i[i(i"L� ��,� .L'I t' 1 <br /> Signat e Date <br /> �c,� r,d= ���,. � <br />