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ELECTRICAL PERMIT APPLICATION <br /> CI i Y OF EVERETT PERMt�T SERVICES 4 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 S ��� / <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org L Qq p5,_Qy'7 <br /> I <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> LJ 2CJ �cr5 � CcqSlYi.o �o� — <br /> PROJECT ADDRESS <br /> � e�-�r"�e� <br /> OWne! �Aail Address Cily State/Zip Phone <br /> Tenanl Mail Address City Slale2ip Phone <br /> C�<�r� S ���� �, ,c 7/�l ZSc�, -,�' �1/�,/sj�,,,�,-� �✓.� `ls'Z�r� <br /> Eleclrical Coniraclor Mail Address Gly Slale2ip �7 Phone <br /> '��-32��.��� <br /> ['l��r,� �r� 3 q/�� ��,ov <br /> Slate Ucense Number Contracl Price of Work <br /> Proposed Use of 8uilding Conlacl Person (Plan Review) <br /> i / > /1 � / <br /> Description of Work lo Bo Done: �E'f���l C �-'-� ��� T'�/ �/�C��( <br /> NOTE: WIRING IN NON-OWELLINGS IS REOUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. I <br /> —� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> !hereby r.criily fhal l I�ave ienA nnd exemined Ihis eppliaution nnd know fhe same fo be t ie and C Oq� -04� <br /> conecf. All prov�sions o!laws end ordinances c�oveming Ihis type o!work will be compleled <br /> whe!!�n�specilied herein or noL The granfin�ol a permd Aoos nof rosume to give nuthonty fo <br /> violefe nr r,encel fhe provisions ol any o(her stefe or local law mguPfing consfrur.hon or flre <br /> peAorrnance o/construcfion Thaf 1 am outhonzed by fhe ownor o/fh�s property fo peAorri the <br /> work lor which apphcation is rnade ond I cornply wifh the Sfefe Confracfors Law IB.27 RCW anA <br /> 296.200 WAC. <br /> � � / ��/ <br /> _.-+.�GLr�r`- <br /> /,. <br /> Sipn:tlurc Dale <br />