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ELECTRICAL PE�NiIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � � � �� 5 � �'^ � <br /> � <br /> s� --,� �� �,C�V �� 1,4 1 � r C <br /> PROJECTADDRESS � <br /> OWner A1ailAddress Cily Stale/Zip Phone <br /> l�e 5'�i` 1 �4t1 <br /> Tenanl Mait Addmss City Slate2lp `c E` ��n;Y <br /> /llu�a � �e S, Gr�.o� Sf; S �q�{C'_ �i�'� 4� �.��' 2. .SG) <br /> Eleclrical Coniractor Mail Address Cily State/Zip Phone <br /> n a� �-� c�(C �-T $ ? ,o��r; �� <br /> Slafe License Number Contrect Price of VJorl: <br /> �'a��1 PC_'���� M�L- <br /> Proposed Use of Building Conlacl Person (Plan Revicw) <br /> Description of Work to Bo Done: I 6I � l�!�� a��L �� �� L C W � �' l l_ S C U V�q S �/ S I C ��� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY(�F EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y certify that 1 have read and examined fhis spplication and know U�e same to be true and <br /> correct. All provisions c'13ws and ordinances goveming fhis f}�pe of work will 6e complefed <br /> u hefher speci�ed herein or noL The grai�ting o!a pemuf Juec not presume fo give authority to <br /> viola(e or cancel the provisions o/any other sfate or focal la�v regu/ating cons6uction or fhe <br /> pedonnance ol construction. That 1 am au(honzed Gy the o�mer o!fhis property fo paferm the <br /> �vork lor which applicafion is made and 1 comp/y wifh fhe Sfafe Con(rac�ors Law 1 i3.27 RC W and <br /> 29G.200 WAC. <br /> � 7 I <br /> �• l �' ��ji >�� (" � <br /> �ignacure Date _ <br /> , _ 1. �� �i � �, � <br />