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ELECTRICAL PERNIIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-885� —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM , � �� �J <br /> d <br /> "�] � ,i-+ 1 ,�-�'-t= ' �. .„ <br /> �` I <_�� ` _.�-� _ <br /> PROJECT ADDRESS <br /> G-1i�T M�-� �-- �/�LC�V1 �G�C�-v l..I�,..IJ'� l l., � <br /> Owner MailAddress �� I � �C�'�1yL, ` n �;�� State2ip Phone <br /> J7.a./c.CJC.)� <br /> U <br /> j�j'-D� �Zt�f�l� <br /> Tenanl Mail Address �ity S�ale2lp Phone <br /> ?i .l.' v =r-�1�� 1=� i=r—P�� Fi�>. -�-I�u � y?7L l�l�.-,tt� ,�� �I�J l�/N:J.11CKq�� Wr1 �1�C�1._, <br /> Elecirical COntraclor � Mail Address � City Slale/Zip Phone <br /> ^l�(�� �:�Z-79[. , <br /> LzIACK-:�L-`�-7f <�_ � cl,Gpo.�z. <br /> Slato License Number Conlract Price of Work <br /> ���aLi_ i��:,_r „ > �'� <br /> L t�I— <br /> Proposed Use o(E3uilding Contact Person (Plan Revie�.v) , <br /> Description o(Work lo Do Donc: i' � -� � �- i , _ " _ ��'.�•:, i _ "�L"�-� i� '=�'�� <br /> �2 I '.� ��i=<�rC `�YLr t� _ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I <br /> 1 hereby certily fhaf 1 have read and exarnined fhis applicafion and know the same fo be frue and I <br /> correct. All provisions o/laws and ordinances goveming fhis type o/�ti ork wdl be cornplefed <br /> �+hefher speclied herein or noL Tho granting o/a permit does not presume fo give aufhonty fo <br /> violafeorcancelthe provisionsolanyothersfateorlocallawregulafingconsWctionorfhe <br /> performance o/construction. That!am aufhonzeA by the o�rner ol this property to pedom�fhe <br /> �i ork!or which application is made and 1 comply nith fhe Sfate Confraclors Law 18.27 RCW and <br /> 296.200 WAC. <br /> _.__- <br /> _y=----� <br /> =_-------. <br /> 3` � � - -� , z5 �n <br /> / <br />� Si natur Date <br /> �� l.� / U� - � � '" '�, <br />