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ELEGTRICAL PERMIT APPLICATION <br /> GITY OF EVERFTT PERMIT SERVICES <br /> 3200 CEDAR Sl'REET, EVERETT, WA 98201 �5�a —�3 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org %�3 a q _)(,8 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO A PM <br /> �� >!'�`�CL�t%�:t_l� �" (�'i <br /> ��l � U <br /> PROJECT ADDRESS `� <br /> I � � ti��(i �ct�1?����(-�'fil�����1 j�zt..� ��. �,�,�;�, �� , ..� ���— `%k,% <br /> ✓IG -(y- L 'r <br /> Ownef �i Mail Addressf� � CNy �� Stal�Zip Ph�ne <br /> P , <br /> TeneM Mail Address Cily State2ip � ,.__ . Phone <br /> ��G:S �7f. t1,s �'t _ <br /> I_S_Q�l% Y�Zf�/'l•C�GV� ��; �� � ���1� 7t����C'�C�l•-, /.��` ����'!-��`�:�7a� <br /> Electrica�Contractor Mall A dress City . SWte2ip Phone <br /> j � / /1 //1 t ' ���'l�-1 ���� C� <br /> ate l�cense N mber �� Conlract Price of Work <br /> j�� r��n r�ir`;t�i��' l�"lf� � �L/,�j <br /> roposed Use of Building Confad Person (Plan Review) <br /> �,. <br /> Descriplion oi Work to Be Done: ���,( f(-t-i"� ���'L� ���� ` `" "`--�7 �)���� <br /> . <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�IUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> .., <br /> ��; �� �,� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby certily Iha(I have read and examined this application and know the same to be!rue and '7� �I _ , ' <br /> correcL All provisions o/laws and ordinances goveming fhis type ol work will be complefed ��� ( � r � �' '� <br /> whether speaGed herein or noL The granfing ol a permd does not presuma to give authonty to <br /> violate or cancel lhe provisions ol any other stafe or local law re5ulating wnsfn�cfion or fh� <br /> performance ol construcf�on. That 1 am authorized by the owner o/this property to perf�rm the <br /> Iwork lor which application is made and I comply with the State Contractors Law 18,27 RCW and <br /> 296.200,WAC. <br /> i� � <br /> ��� "�� � � �i�� � �� � / <br /> Signatur2 e <br />