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J <br /> � <br /> ELECTRICAL PERMIT APRLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> #25-257-8810 - FAX425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� (/ �.« c(�-/n/'�i . ( /G£`/� , <br /> C�� � /I. C_ :,�r <br /> PROJECT ADDRESS � <br /> Owne� Mail Address City� / 5tatelZip Phone <br /> ' �'^ „ �/cYII�'� �%'�,CC�dG�L-GGCI <br /> ' �i ,�1 <br /> �iF ^ � -� !'L[.✓iyr-�2'/ <br /> Tenant � f Mail Address City SlalelZip Phone <br /> ��� ' <br /> � ��,���5� �(./L���/L ���,, : ��>��s� r(,�,��r,/� ��������=���rz,� <br /> EleClriCal Con�faclor Mail Address City StalelZip Phone <br /> ii�l,�c=5j1150 =;jl.'�/Z'_ ``� <br /> hCc� <br /> Slate License Number ° Contrad Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> �1 / /� i <br /> Description of Work to Be Done: L�� S %i�C �'` L G`/L/i f F� J/� J���r'� <br /> 7 ��� <br /> � Tx � s ��� i�, /��'���r/� <br /> NOTE: WIRING IN NOIv�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 here6y certi(y that 1 have read and examined this application and know the same fo be true and ��� � 'z —U�j 4, <br /> correcL All provisions ollaws and ordinances govemmg this type o/work will be completed <br /> whefher speci(ed herein or noL The granling ol o permd does not resume to give auLtionty to <br /> violafe or cancel the provisions ol any ofher sfate oNocal law reguPfing construclion or the <br /> performanc�o/conswction. That I am authorized by the owner oI this property(o peAorm fhe <br /> woric(or�vhich application is made and I compty�vith(he Sfate Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> i <br /> � ���. �� �'� .� �. <br /> Sign�W� , ;j ale <br /> � , <br /> � <br />