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, <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �� _o �-07 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857-www.everettwa.org C O71 U �OQ� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��iy �:�/.�y ,���. ������ � w� 9;�� �-i <br /> PROJECT ADDRESS <br /> �' //��� / �y / �/ �%' '� 'I�f, �//' �'�/({��/ p�- ,�/� �f�2�/ <br /> ���� V/ZC��CY� � , � ! • L.� / <br /> ner Mall Address City Stale2ip Phone <br /> Tenanl Mail Address City Stale,'Zip Phone <br /> �t?�/�-E; ��I� /Z`120 � 7�.�s� .5�� �� t t��4- ��'O�'C' <br /> Eleclrical Conlraetor Mail Address City State;Zip Phone <br /> �,c-��L � 93A✓� .z I Z,�o. �o-�� <br /> State License Number Conlracl Price of Work <br /> �/%/����S .-�¢ �*IL, Ijlc,C' <br /> Proposed Use of�uilding Conlact Person (Plan Revimv) <br /> Descriplion of Work 10 Be Dono: �// �/E �����C� � Cv�'�K %~� �/�"�/ <br /> `i�/7�ti r �9c�� s,a-e�.v,� i.vs�:r//,�Tic�-� �ti�� .S'o�,r,�--/' <br /> ; <br />� Si S���-� <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 hereby certily Uial l have read and examined Ihis application and know the same to be true and <br /> correcl. All provisions ollaws and ordinances govemmg fhis type o(work will be completc-d <br /> �vhether speci�ed herein or noL The c�ranfinr�o(a permrt does not resume!o give authority to <br /> wolate or cancel lhe r�rovisions of any other state orlocallaw reguPating constn�ction or the <br /> performance o/conslroction. That I arn aulhonzed by Ihe owner o/fhis property lo periomi the <br /> work/or which application is made and 1 comply with the Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> , ,��G�� ��c�l�.�/ ��' �- 0 7� <br /> ;� Signature Date <br /> �G1 (Q - �� <br />