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ELECTRIC�►L PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857-www.everettwa.org `� �"� ��� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � <br /> in-��� ���k�e� c,���/ <br /> PROJECT ADDRESS <br /> _Jo� �ia�AlAi�O <br /> Owner � Mail Address City Slale2ip Phone <br /> �',G�%el�t�/�iS� �r�11 /� CG.�� <br /> Tenant Mail Address City State2ip Phone <br /> , '�;��aki� �����a���✓ /c�717 /6� ��si ►?�u�i��� i �q �'rs37�/ as3-�ao -�7�3 <br /> Electfical ConlraCtor —T Mail Address ity Slale2ip Phone <br /> � - -Z�- �7 <br /> si��.��G � 95 i�� ✓ �"/Sa�`�= <br /> Slate License Numbe; Contract Price of Work <br /> �.4k'- lZcPit�l�� D`N/C "� <br /> Proposed se of Building Contact Person (Plan Review) <br /> Description of Work ro Be Uone: I u`��'4�I Dti�L �X� � S��4�Y� /a I � �- r t'�'4(`'� V'-� ti �� <br /> ���v,��l l'c��n�i��= - �ui�� N«� c�olZe� s�{;�c� SW� " y DAiA �.opS <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 that 1 have read and examined this application and know the same to be true and <br /> correct. All provisions o/laws and ordinances governing fhis type o/work will be completed <br /> w�hether speci(ed herein or noL The granting o/a oemut does not presume to give authonty to <br /> violate or cancel fhe provisions of any other stafe nr local law regulating consfruction or the <br /> pedormance o/construction. That 1 am authonzec by the owner o/this property to peAorm the <br /> work(or which application is made and 1 con�ply wrth fhe Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> --�1 <br /> .�/.�__� y�7 c� � <br /> Signalure Date � <br /> � <br /> y�p i� l � <br />