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i <br /> 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 /> � ' <br /> n > <br /> i" ' � 1�., ' !; '� Sf� i �� , � <br /> � <br /> PROJECT ADDRESS <br /> Owner Mail Addross City Stale/Zip Phone <br /> � a <br /> �i I��t'� ���f(G'�1 <br /> Tenanl Mail Address City Slale/Zip Phono <br /> � � J � + � 7� i 9 ° ��� (5� ��.��/ <br /> F� Il�l� � '_(� (, il!('4Q C l�r"u'�C y���/ �l ,�t �l= �E'tiC[� a /. <br /> ElectricalConlraclof � MallAddress Cily SWte2ip Phone <br /> ,�(^(�(��, <br /> Stalo Liceose Number Conlract Prico of Work <br /> LC'� )'i�i� (rrrL <br /> Proposed Use oi�uilding Conlacl Person (Plan Review) <br /> p ' " S fri l� �1� ,1.'�'f�� �' ` ��'� � N�'��� I���I�/' /'�l!'l� ��� <br /> Descri tion of Work lo Do Dono: ;- i( <br /> 1 I/r r i (j' � <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CA[3LE. <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> l hereby cerfify fhaf 1 havo read and examined fhis application and know fho samo fo L•o We and �I U� � — G� �- <br /> corrocf. All provisions o/laws and o�dinances governing Uus fype ol work will be compieted <br /> �ahe(her spea(ied herein or noL The�ranfing o(a pennd does not J�resumo fo give aufhonty to <br /> violafe or cancel the provisions of any other sfafe or local Inw regulating constn�cfion or tho <br /> perfonnance oI cautruction. That 1 am authorized by fhe owner o/this propeil}�to perlonn the <br /> work lor which applicafion is mado and I comply with fhe Stafe Confrectors La�v 18.27 RC W and <br /> 296.200 WAC. <br /> _-> � . <br /> � �l <<C�'�'1 _ ,'1/ > I�; <br /> � SiunaWre . -- 'Datd <br />