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. „ <br /> �LECTRICAL PERMfT 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 /> -� � _ <br /> ., � 3 � L� ; �.<< <�.�-r <br /> PROJECT ADDRESS <br /> Y1��� , ��� ..� ��u�.� ���_ '�,��� �� l=�� �r r� w� K�a�� � <br /> Owner Ma!I Address City StateZp Phone <br /> � 1 IrV�1 ��Z1 ✓� {"�� l � � t� �C- I `�(4'�l �' ✓ l,�(��T1 � �A.�i� �� ') �L'"� ���•��/����'"�1 ��3 <br /> Tenant Mall Address Clty Slate2ip Phone <br /> -'� <br /> � SC"� ✓V i�' '� �, '� -���� t� , c -� ��., � �yC��: ; {z�r;�_��•^� l�i�( L=,.rrt � � . l.U� `J ��, � <br /> Electrical COntractor Mall Address City StaleZp Phone _, <br /> '9}��� -7 i L S Y i "7 <br /> ��'�� ���L,�-, 5'� L� � /c;u . �'v <br /> State Liconse Number C6ntract Price of Work <br /> � '�,�. T.-��l��ilt:� �- <br /> 15�1,� 1,� <br /> Proposed Uso of Guilding Conlacl Person (Plan Review) <br /> DescriptionofWorkto �eDone: � ° SI�� �� ( •�,� 1C'j"( C �\ c �til�lay � �:"�U� <br /> /. -� �- .'_ U cl ��..� 1^��.����`{M11 . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> 1 here6y ceRily fhat/have read and oxamined this applicafion end know the same to be true and <br /> conect. AI!provisions ollaws and ordinances Aoverning thls typa o(work will be compleled <br /> whether specified horein or noL The granfing o/a permd does not presume to give authority to <br /> violafe or cancQl the provisions o/any other state or local!aw regu/afing construcfion or the <br /> peAormance ol construction. Thaf 1 am authorized by fhe owner ol Ihis property to pedorm Oie <br /> work lor which application is made and I comply with fhe State Confrac(ors Law 18.27 RCW and � <br /> 29G200 W.4C. <br /> , <br /> � � ��� �/����'l� �� <br /> /�c�,,-- �, <br /> � SipnaWre � ate �jV <br />