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�- - <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 2- 3 -1/ <br /> 3200 CEDAR STREET, EVERETT, WA 98201 C�� p�—O r7 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> G � IS �� (�-o�✓ ST <br /> PROJECT ADDRESS <br /> �ttc �Ue.✓�e,7i' <br /> Owner Mall Address Cily Slate2lp Phone <br /> Tenanl MallAddress City Stale/Zip Phone <br /> �1 .1�'.��1 �I���2A� �'�!� / �, �,Zs.,z� <br /> - �=(.�rl C ��C �� ,��M. ��i/.� . �J r�c�,3 3 3'3 3 <br /> Electrical Contractor Mail Address Clty Slale/Zip Phone <br /> �/ �e, �l �i�19D�' �� <br /> Siale License Number Contract Price of Work <br /> ��o✓l��-�c- <br /> Proposed Use oi Buildinc� Contact Person (Pian Review) <br /> Dascription of Work to �o Dono: �-�'�R LU)� ��'� I �i t�' <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 <br /> I h�reby certify tl�at 1 have read and exnmined this application and know the same to 6e truo and <br /> correct. All provisions o(laws and orclinances govenun�this typo ol�rork will bo completed <br /> �vhefher speci/ied herein or noL The c�ranfing o!a pornut does not presume fo give aufhonty to <br /> violafeorcancel(he provisionsolanyofherstateorlocnlla�ti-re�ulefingconstrucfionorfho <br /> pe�fomianco o(constniclion. Thnt 1 arn oufhorized by the owner o/0us property to peAomi the <br /> work ior�vhich appllcation ls rnado and 1 comply tvifh fho State Confroctors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ,� "�� ����j il � ��. - o� I <br /> �, a, <br /> Sic�naturo Date <br />