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GLECTRICAL P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 G`�j,��/D <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org C/4o6�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �����" � -�r�lU w, �c��,�r -�,��e _F <br /> P�tOJECTADDRESS � <br /> l/�1'Ylu� ��� <br /> OWnef Mail Address City Stale/Zip Phone <br /> Tenanl Mall Address City State2ip Phone <br /> U � ._1 I J 551�: � an �II ^ �I ? GIaS � <br /> EleCir' ConlreClor Mail Addroes City Stale2lp Phone <br /> lf-�1<L/�1�1-�i�'.�-f� 1�i�1. <br /> � <br /> Slale License Number Conlract Price of Work <br /> ( 0 n1 E'r(��C �.��T�ti � <br /> Proposed Use of 6wlding Conlacl Person (P�an Review) <br /> Descnption of Work lo Oo Dono; �� l� � �t rn <br /> I^ ,, � <br /> J C' G � � ✓ , YV IC11' - <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> B6 IN RACEWAYS, MC OR AC CABLE. �� <br /> ��' <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that 1 have read and examined fhis applicafron and Wio�v fhe same to bo frue and <br /> correct. All provisions o/laws and ordinances govemm�t0is typa of u-ork�sill bo complefed <br /> �rhefher speafied herein or noL The granting oI��pemut does nof �resumo to givo aufhonty to <br /> violate or cancel tl�e provisions oI any olherstate orlocallaw regulafing construction or fhe <br /> performance of consiruction. That 1 am aufhorized by the onvier of fhis properiy to peHomi the <br /> work lor�vhich application is mado and I comply�vith fho Stafe Contractors Law 18.27 RCW and <br /> z9�.2o0�vA�. a� � _ �a <br /> , , <br /> t_ _��='�- Iy > , <br /> � , <br /> < <br /> Signalure Da e <br />