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�— <br /> ELECT�ICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � a�_��7 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.ory Lro7��_�73 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �, `� 6 �6 -G a l-'�-�3 <br /> //c�t��t �`• ,•G;1•'e��c��.' C�Y <br /> PROJECT ADDRESS <br /> �' <br /> � I� �i< 'c; ��-,;r' o ,� , LL ' Z� i';-a; ^i , � _ ��o; <br /> OwnCf �� Mail Address Ciiy Slale2ip Ph6ne <br /> C� �•�C ��n ���, I � �' :1 �V ✓"�;y� r (.,C> CV rirfC 1�.� <br /> Tenant Mail Address City StatelZip Phone <br /> / r /, ) /� I r <br /> ( 1' —�'r�-1,` � `'i`i ~U J �S� /=1b.-- Sln� -�'i'' Jri-•,.' Ia r^� C� GC Z� <br /> Elec rical Contractor Mail Address City State/Zip Phone <br /> C�' �_� r�a� �:�.�j k �- -- <br /> Stale Li•ense NumL�er Contracl Price of Work <br /> ,--�i,w,r,� ���� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> .,r- <br /> Description of Work lo Be Done: :�� F'-f"� �._• � � ��— +� � �� � � ��' � <br /> / <br /> / <br /> NOTE: WIRING IN NON-D\h'ELLINGS IS REQUIFF.D TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereGy certily that 1 heve read and examined this application and know the same to be frue and <br /> conect. All prnvisions olla�vs and ordinances goveming th�s t}�pe o/work will be completed <br /> �vhefher speci6ed herein or noL The granting of a pennd does not presmne to give au(honty to <br /> violate or cance/Ihe provisions ol any other state or local law�rec�ulating construction cr the <br /> peilormance ol construction. That I am authorized by fhe owner ol tlr�s property to per!orm the <br /> work Ior which applica6on is rnade and 1 cornply with the Sfate Confractors Law 1827 RCW and <br /> 296.2G0 WAC. <br /> _ — <br /> _ _. _��_ _-_�_- — '��,� •1 :.� <br /> i / 'G' / <br /> ignaWre Date <br /> 4� C/Z�i'��� <br />