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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 Sr1g,�S <br /> 425-257-8�10 - FAX425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO d PM � y 0 �S �yl <br /> ���7 11r c- <br /> p�C� �Ue'!-c "�('_ � �C �i <br /> PROJECT ADDRESS �' <br /> �-]- f � � ( f n c- <br /> �.IGIC 6C I ti � l-c 1,OX' O�1C_� ? ��'�� o-L.' � (�-e-1-i �'�C- 2 �.1..��,�.' <br /> Owner Mail Address Cily ` tatelZip Phone <br /> � e G' i In �� D��c �c U^2 c�. �'�6oJe <br /> Tenant Adail Address City StalelZip Phone <br /> 3Go-ga�-700� <br /> � • �-2 FC� c�lt �„� Co 860[� ,u�' ��—" PL, ����rcoctvec� ��-? 9��� <br /> Electrical Conlractor Mail Address Ciry 5tate�zip Phone <br /> FtiIE(?�fC 9S� C �U -(� S �,� .C?C_, <br /> Slale License Number Contract Price of Work <br /> Proposed U��o(Building Cont�Person (Plan Review) <br /> Description of Work to Be Done: S vr�e ✓�� r� F�Q�t t r,�.� c F r�ct 1 � � 1— ,�0 4 un� (+�r'��( � {- <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 C!��� I l., 1 <br /> I hereby ce�tily fhaf 1 have read and examined this application and know the same to be Vue and �Uz� <br /> conect. All provisions o(laws and ordinances c�overning this type ol work will be cornpleted <br /> whefher specified herein or noL The granting ol a permd does not resume fo give aufhonty fo <br /> violate or cancel the provisions of any other stale or local law reguPating construction or�he <br /> periormance o/construclion. That I am aufhonzed bythe ownerolthis property fo perform the <br /> work lor�vhich applicafion is made and I comply�vith the S(ate Contrac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �zw� ���,�-��__ �=�28 -0� <br /> Sic�naWre � Date <br />