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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> "'C�'�:, �/G'�� .. -, <br /> J (�f-�:iINO 1°�onP <br /> PROJECT ADDRESS <br /> I�= I�o��•,� C�c�. Fk� v�h �lol jC-r„Tui W� `i .n^17.y -Zzol <br /> Ownef MeilAddress Clry Stale/Zlp Phone <br /> l � ^ <br /> ��Jf ��LI.�IN.� �JL�• <br /> Tonenl Mail Address Clry Stete/Zlp Phone <br /> �-c'>�� ��G��;�n�o� �l�'�-Tn�r_ 2�1� NlJ p^'C�:c�t. �I h; j��"tlu: � W^� �ja ll7 7,-�5-9�7�ti1 � <br /> EleclricalConlractor MallAddmss Cny Slate2lp Phone <br /> � 6� <br /> � <br /> Fov���co15cH _ _�t��C`-� <br /> Ste�u Lice��sn Number Contrect Pdce ol Work <br /> Proposed Use of Ouilding Contact Parson (Flan Review) <br /> Description ol Work to Be Done�. F�-<<n�TLiiv� �iTit t-l- `-�'L - 1�L'av `�'nS�Jd.E. Fti� <br /> 1{�-A�.bQ <br /> �L:N Y;,'_�,-�U-{ <br /> NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITV OF EVERETT LG..AL SALES TAX CODE IS 7106 <br /> 1 herob y certJy fl,at 1 have read and oxamined fhis application end know the same fo bo truo and <br /> coiroct. All provisions ol laws and ordinancos govemmg this type ol work will be completed <br /> whothor speciliod horoin or noL Tho gmnfing ol o pernuf does notp resume to givo authonty fo <br /> v�olalo or cancel the provisions ol any of6or s�afe or/ocal law rogulafing Conshucfion or fhe <br /> pedormance ol construction Thet I em avfhonzed by fho owner o/fhis proparty to Oorfomr fhe <br /> v�ork Inr�rhich aPP��ca�ojrs m�do and 1 compty wifh the State Confrac(ors La�v 78.27 RCW end <br /> 296200 WAC. <br /> :j �- <br /> ��� ��i.- �l./'�/i72� <br /> � Da � <br /> - '� <br /> E v9��-o��3 <br />