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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES ��,a� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 7 <br /> 425-257-8810 - FAX 425-257-8£57 -www.everettwa.org L p60��p�� <br /> APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I <br /> _ � <br /> _ � � 1=�(�;C�i� �� ',(.t.ST L�/�+c _ <br /> PROJECT ADDRESS <br /> ,'ac� ��tv._-�i �f�e �✓e/'�� �..9 Y82c� �ZSz�!-I`fr�i <br /> Owner Mail Address � City Sta(e/Zip Phone <br /> S+�n�t <br /> Tenant Mail Address City Slate/Zip Phone <br /> q �' . <br /> L (A. ��� ��1'Y t� <br /> Electrical ConVacbr � Mail Address Ciry StatelZ�G Phone <br /> �'.� tic <br /> �GG � <br /> State License Number Contract Price of Work <br /> kcS7 . _ 4-i�-,�,��y <br /> ,Oc.,c r (�a.�� �c <br /> Proposed Use of Building T— Contact Person (Plan Review) <br /> Description of Work to Be Done: L�-E r��«'�L- �(✓n/��['r7G ti ni � 4kt�J �'r �-� <br /> � 7 ' � � / ' - ! Cl/°L ' T <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 /> 1 hereby certily that I have read and examined this application and know the same to be true and <br /> coriecf. All provisions ol laws and ordinances governing th�s type o/work will be completed <br /> whether spcci6eC h�rein or noL The granting of a permd does not presume to give authonty to <br /> violate or cance/the provisions o!any other state or local law regulating consfruchon or the <br /> ;�crformance o/construcGon. That I am aufhorized by the owner of this property to perlorm the <br /> i work lor which application;s made and I comply with the State Confractors Law 18.27 RCW and <br /> � 296.200 WAC. <br /> � � <br /> � � ����-=����-- 7- /��-C� <br /> I Signature Dale <br /> � i <br /> i /�C�� , � � <br /> � -- - __ _ — l <br />