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i <br /> EL�CTRICAL PERMIT APPLICATIOIV <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32on CEDAR STREET, EVERETT, WA 98201 ��•.l�9 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org G ,,,p) 2�.'�� <br /> (J / <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � O 1 o r�. ��- �� f�/� . <br /> PROJECT ADDRESS <br /> w�I � ��� � ��r.�� � � ,�,= . <br /> Owr er Mail Address Clly Slate/Zip Phone <br /> Tenanl Mail Address City Stale/Zip Phone <br /> (' QI lV <br /> �..��J 7 i— �M 1-c-�= c.�vl-� C_ � ( v� l 5 6�� � 5 i�.�J L ��,�.U, wA . <br /> Elec�rical CJnlractor htail Address Cilr �`J,)� Stale/Zip � Phone <br /> �° �(Z i- zSZ ' 87 Se <br /> I.�7.) J O i—��S � �_ � v �- <br /> Stalo License Number Contract Prico of Work <br /> C i� <br /> Proposed Use of Building Cunlacl Person (Plan Review) <br /> DescriptionofWarkloGeDone: �����Z C�� �J�� � ��/� �'Qtir.-L <br /> NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO FEE <br /> OE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> f hereby certily llmf 1 have read nnd exnrnined this applicntion and kno�v tho same to bo true and '���L,� �'.l-> <br /> correcL All provisions olla�vs and ordinancos go��emmg fhis fype of work wil�be completed � <br /> �vhe(her specified hereir ornoL Th��rantinc�o(��pemuf does nof presmno fo give authonty to � � � �� v <br /> violate o�cancel fhe�rovisions ol any othor sfnfe or locel lt�w regulofing wnsfruction or fho <br /> performnnce of caistruction. Thaf 1 am authorized by Yio o�rner o/this properiy to pedorm fhe <br /> �rork(or�vhi„h�a�plicafi0n is nmdo and 1 cornply wifh fho Sfafo Confr�cfors Law 18.27 RCW and <br /> 29G.200 WAC <br /> : <br /> �'� ��L I � � � � l � �.; ✓� ) <br /> Sipr luro Dato <br /> i <br /> � <br /> � _ <br />