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ELECTRICAL F�ERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-881U - FAX425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � i <br /> . �— �'./1 . '-� l. - � ' C. / � <br /> l , lr r ll <br /> PROJECT ADDRESS � <br /> , <br /> � - - , . / � , . �" <br /> > . � � � ' ��L ( <br /> OWner A1ail Address City SlatelZip Phone <br /> � l <br /> "l_. <br /> Tenant Mail Address City State/Zip phone <br /> (�� ��>���c;ry �_' l ��r `� ,'c"�i /,�/v'r; , i' � vl> fi� ;';y" '[s �';S� �:s Sca�� <br /> [lectrical Contraclor Mail Address City State/Zip Phone <br /> �� 5 �.\�UCi�'`l7 �lU ' ^' ���� f <br /> State Llcense Number Conlract Price o(Work <br /> � . � <br /> � "C�'��(� r f- <br /> Proposed Use of 8uilding Conlacl Person (Plan Review) <br /> DescriplionofWorktoBoDone: ,�p I 'L ����( (� �_v(��;/ �-' i— i�� � i-�� Lj f !c� '�,�� _ <br /> � 't , <br /> �� ,-' f ��( -/ ��(!J _ �r�f,j^ �'CJL2 - J �:�Lf�� <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, �4C OR AC CABLE. <br /> CITY OF EVERETT I.00AL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf 1 have read and examined Ihis application and know the same;o be 6ue and <br /> conect. All pravisioes o/laws and ordinances govemmg this fype ol work will be comp/eted <br /> whether speciGed herein or noL The grenfing ol a pemuf does nof presume to give authority to <br /> violafe or cancel the provisions ol any other sta(e or Iocai law regu/ating construction or fhe <br /> perfonnance ol construclron. Thaf 1 am aufliorized 6y the owner ollhis property fo pe�fonn Oie <br /> work lor which applicafion is made and 1 comply wifh Ihe Sfa,e Con(ractors Law 1827 RCl4�and <br /> 29G.200 WAC. <br /> j � i ( , <br /> _ � '� � �'�(� ��� �C �"�'� � i I � � j— �ii� � � <br /> Signature Date /�/ <br /> �� `/�/ — CJ��/ <br />