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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 6 ....� --(JG <br /> 425-257-8810 - FAX 425-257-8857—wvwv.everettwa.org <br /> ��06 ob-o� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � / <br /> � / � <br /> PROJE T ADDRESS <br /> 1N� ,S � ��r 1�,J L=Vere� Ir�l�}- �8�-0 3 <br /> Ownef Mail Address City SWte/Zip Phone <br /> Tonanl MailAddress City Slale/Lp Pbone <br /> zov- <br /> (�r���woa� EjP� .D, �� 3a7a8 S� w' . 9�i/3 J83-�9 J <br /> ElectricalCoNraGor MailAddress City � State2lp Phone <br /> (�/ ���c��; �S o� , �� <br /> (��'e��✓G''7 99SD7 <br /> Slate License Number ,, .Conlracl Price of Work <br /> 5�;�� i� ����� � i�f��� k N� (�N �c� �55-���0 <br /> Proposed Uso ol Buildiny Contacl Person (Plan Review) <br /> /� 1 <br /> Description of Work lo Bo Uo e: �� a �r ���� /� /�� � .!� e� <br /> �� ��P I O✓V �� � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVEREtT LOCAL SALE5 TAX CODE IS 3105 <br /> 1 hereby certily that I have read and examined ihis applicafion and know fhe same fo be frue and <br /> conect. All provisions o//aws and ordinances govemmg fhis rype ol�.ork will be cornpleted <br /> �tihether speulied hemin or noL The granfing ol a permd does nof resume to give authordy to � <br /> violole or cancel the provisions o/any ofher stafe or local law reguPating consWction or the <br /> perfonnance ol construcfion. That I am autHorized by fDe owner o(fhis property to peAomi the `� <br /> a�rk lor which applica(ion i ntade d!comply with the State Contractors Law 78.27 RCW and <br /> 296.200 pI�AC. j \ � <br /> ' j�� / / i 1, <br /> �/ �/� �% � � � ��/� (O ��� <br /> �gnafurc Date � I <br /> \ Y <br />