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ELECTRICAL PERMIT APPLiCATIOIN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � � a'"�� <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org `0�Ic,Q /j <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> ,��a5 -�ib��_ ���.. <br /> PROJECT ADDRESS <br /> �k61"'c�c� I� ( �N-f�r�c�� s�� =�70"7 �011�.���� fZ�J Cv-�e�'�8�o J� <br /> Ownef Mail Address /� M ,.., Cily �� ���c�p� ^�� ,�, Plionc I <br /> 'J/ LJ 4L��.i �-j r�.� <br /> � �—l.+'� <br /> Tenan�^��~� � � Mail Address Cily Slate2ip Phoce <br /> �c�5�„� ��rk, � c�����c �t�o �'�a,et1, �. �B.�G 't�-�9-���r1 <br /> [IeClrical COnlraClor ldail Address City Stale/Zip Phone <br /> � � s��� 153 �.t� � �75°� <br /> S'late License Number Contract Price of Work <br /> �es�f a���,��-t--� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work to Be Dona: 7'�v,� l,Uv�l r0� W 1��r��% L,GW �O,�G��i <br /> NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> C����cl _ O � ;'� <br /> 1 hereby certity fhaf I have read and examined this applicafion and know the same to 6e frue and <br /> sonecf. All provisions ol/aws and ordinanr,es�ovemmg this type o/�rork will be completed <br /> whether spea�ed herein or not. 77ie granling ol a pennd does not resume(o give authonly fo <br /> violate or cancel fhe provisions o!any ofher sfate orlocal la�v regt�Pting consfruct�on or fhe <br /> performance of construction. Thaf I ant aufhonzed Gy fhe owner o(fhis pioperty(o pedorm the <br /> work Ior wbich applieafion is rnade and I compty a�ilh fhe State Contractors Law 1827 RCW and <br /> 29fi.200 WAC. <br /> �L� � �`-'-- �-Z�� B <br /> " SignaWre Date <br />