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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 42G-257-8857 —v,nvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �-1t i nt � �/)��j,L�G,LI� <br /> PROJECT ADDRESS � <br /> s�-�'�� �t,.��� l� <br /> % �� al� � - � l �'����Y <br /> Owner Mail AdOress City rStajr¢ip � Phone <br /> . �r�� <br /> Tenant MailAddress City State2ip Pnone <br /> Eleclrical Conirador Mail Ad�2ss City Stato2ip Phone <br /> Sfate License Number Conlract Pnce ot Work <br /> .�'f e r� �� ��1-s'/ <br /> Proposed Use oi Building Contacl Person (Plan Review) <br /> y � �/'y �.Jy� �1 i , <br /> Descri lion of Work to Be Done: Q[ �j (/ l ��'� l��/� /sl�i �.�,C //�/� / <br /> P i ��! �-+ /�..� <br /> �-� ����li L1_.ct.f .o o.,_ V�I/-� L— <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certily fha(!have read and examined this application and know the same!o be true and <br /> conect. All provisions ollaws and ordinances govemuig fhis fype ol�vork wil!be complefed <br /> whether specdied hernin or noL The granfinq o/a peimd does not presume to give aufhonly to <br /> violafeorcancelthe provisionsolanyotherstaleorlocallawregulatingconsfructionorthe . � <br /> pe�formance of consfruction. 'fhat I am authonzed by fhe owner ol this propeAy fo perlomi fhe -�{� �" �i(�� <br /> wo�k lor which application is n�ade and 1 cornply rvith fhe Sta(e Confraclors Law 18.27 RCW and �y- V �J U <br /> 29G.200 WAC. �� <br /> / /;/%/� � �% C�'% <br /> -*-- <br /> � SignaWre � IJ�ic <br />