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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, 1NA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everetlwa.org (J -l� �U�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��v �l/-O� 6 <br /> � �U� C�. (..0���C�� L j"i U/!T � <br /> PROJECT ADDRESS �25� <br /> ` �\ ,, ' ,p 3T� - ,_ <br /> �F'l/\ 1�/�-� f�5��"�2 l S v�+r�j'l�� �U��,G�� � �'�IO � ���a 3 /U )`�5 <br /> Owner Mail Address Ciry Slale2ip Phone <br /> �� <br /> Tenanl Mail Address Cily (� State/Zip Phone <br /> i <br /> �c�,—� l�N��5 �j-�C `(��% �/�.`_.c✓A�� /J< S�,�TIZ—� G.;<' �%� <br /> Electrical ConUaclor Mail Address CI y Stale/Zip Phone <br /> �C�"�.�z—`���� <br /> �-�-�-� /ln i, cv'] 3 � <br /> Slate License Number � Contrect Price uf Work <br /> (';�,'�� ���/C� <br /> Proposed Use ot Building Conlacl Person (Plan Review) <br /> �^ <br /> Description of Work lo Oe Done: �-)� S4'-5 � ���— <br /> �' `�r-:.�,(==`:=,G� 2 �4�>r�.05 � Sc�! c�-� �=£i�S <br /> �rr����';�-��% , <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 /> !hereby cerfily thaf I l�ave read and exarnined fhis application and know lhe same fo be frue and <br /> correct All pi�visions oflaws and ordinances goveming this t}�pe o/�rork�vill be complefed <br /> whelher specified herein ornot. The granting o/a permit does nof resume fo give authonty to <br /> viola(e or cancel fhe Provisions of any other state urlocallaw reguPfing consWction orfhe <br /> perfomiance of construcfion. Tha(1 arn aidhonzed by Ihe ou�ner of fhis property fo perfomi the <br /> work foryvhich application is made and I comply�vifh the State Confractors Law 18.27 RCW and <br /> 296.Z00 I��AC. <br /> I <br /> i , <br /> II <br /> ��;�"L s�;� — � , lJ <br /> � Slgnatu _ ate - <br /> r <br /> � : r <br /> ' .�d8ll-G! !� <br />