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ELECTRICAL PERMIT APPLICA�ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 4�5-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,`��(o ���Uo�l S�- <br /> PROJECT ADDRESS <br /> �DrFtv l7C-r�(z��.Kf� ��CC �F,Ub-I.OPiu�7,r'� �V�� 1/�P 1�3_�- <br /> Owner Mail Add ss Cily Slate2ip Phone <br /> Tenant Mail Address Ciry State2ip Phone <br /> L� � c�-�N� J�o F�� a��� L�i+�rsw� � �1� y2s �u2 ��� `I <br /> EleGtrical ConlraClor Mail Address City Stale/Zip Phone <br /> ���=1_LCCy��j�p�� <br /> StalQ License Number Contract Price of Work <br /> P� �� �Z��1 �I> ��if� <br /> - , <br /> Proposed Use ot Building Contacl Person (Plan Review) <br /> ) � <br /> Doscription o(Work to Be Dane: �-�E�'�\ct �i\Arvr�� ��� �i d �U � (.,,v,ti�,/7 <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 3705 <br /> 1 hereby certify fhat I have read and examined fhis applicafion and kno�v fhe same fo be We and <br /> conecL All provisions of laws and ordinances gove�mng this type of work will be compleled <br /> whefher specified herein or noL The granfing ol a permit does not presurne ro give authority to <br /> violafe or cancel fhe provisions o/any ofher stafe orlocallaw rec�ulafing cons!rucfion or the <br /> perforntance oI consiruction. That 1 om aufhonzed by the owner o(fh�s propedy to peAomi fhe O <br /> work for which application is made and 1 cornply with Ihe State Contractors Law 18.27 RC W and � <br /> 29G.200 W <br /> / <br /> �� i 2�Z1 �p.� �� <br /> Si natbre Date � <br /> � <br />