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ELEC�QICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 35 / 5 /�/���� /-1'l l� U� <br /> PROJECT ADDRESS <br /> 1�,,,�2��� C{.�.z 35rs l'�,��,�-y" �r�� ���,, ��L-i ��5 ��.i <br /> Owner Mail ddress City Statc/Zip Phc�e <br /> Tenant Mail Atldress Ciry StatNZip Phone <br /> �';'r,�-;1,� ;i� �GG-c;�;r��� Fo .�x?x �i�S �dn�rt.� �ti'/1 �%5���� <br /> Elecirical Contractor Mail Address City Stale/Zip ��L�, j(,ZPhPJ�S U <br /> y <br /> �/2�n� G ro � 7 � w a�oo ov <br /> �ale License Number Contracl Price o(Work <br /> Proposed Use o(Building Conlact Person (Plan Revie�v) <br /> / � �—Lv <br /> Description of Work to Be Done: �C,�' �l�N� �/� �i t CJL ��L 1�Vv���, r �� � <br /> �-1-Y�nIrG-r� �� �'l�C.v� � ��� , � �v , ���".h,z <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOGAL SALES TAX COOE IS 3105 <br /> I here6y cerfi)y fhat I have read and examined fhis applicalion and know fbe same to be true and <br /> conect. All provisions o/laws and ordinances govemm�fhis typc�ol�vork wi/16e complefed <br /> whether speci6ed herein or noL The�ranting o1 a perrtut does n�t �esume fo give autho�ity to <br /> vio/ate or cancel lhe�rovisions o/any other sfate or/ocal law reguPfing consf�uction or the <br /> per/ormance olconstruction. That I arn authorized by Ihe o�vner ol this propedy to perlorm fhe <br /> wo�k f�r whicb applicafion is made and 1 comply with fhe:!afe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> i <br /> �� ;` �L^� � �rL � � �'�''�' �`� <br /> Signat ue Date , � <br /> � <br /> r�� � <br />