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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ��-a�/b <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org - <br /> (__/b�2-��7 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �?,J1�� �Cz �N �(C. �/% <br /> PROJECT ADDRESS <br /> ��/�� .SC:�r1� <br /> OWner ldail Address Clly Slalei�ip Phone <br /> /D ��// Z <br /> Tenanl A1ail Address City Stalc2ip Phone <br /> / � / /, �� .�OL <br /> i.'1L�^�1Z��eC- 4�//r /�a�"� � S� j�C' CG'fG��Ji�c'l'� GGtr - T�2'.� G 7/`/-y�,Iy. <br /> [leclrical Conlnctor Mail Address Cily ' Stale/Zip Phone <br /> /i'��( L� � � 7� /% �GY� un <br /> Slato Liconse Number Contracl Price o(Work <br /> /� ���h �c� s. Cao•� r�ar.�' <br /> Propased Use of Building Conlacl Person ( 1 n Review) <br /> Dascriplion of Work to Be Donc: _ iliptt/ ra/) q cN.�i .� y(� L/. �p.y�{��,C� �/C�/ <br /> j .'7J�n I 1r,�:��� NA/1 if� � <br /> / <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO F[E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> /he�eby ceriily fhaf/have read and ext�mined fhis application and kno:r fhe sarne fo be frue and <br /> correcL All provisions of laws and ordinances govenung fhis type ol work will bo cornplofed <br /> �vhefher speciGed hercin or noL The�rantin�o(a permrt does not resume to give aidhonty to <br /> violate or cancel the provisions o(t�ny o0ier state or local la�v reguPfing consWcfion or the <br /> performance o(conslruction. Thaf 1 ain authorized by fhe o�vner ol ih�s property fv perfomi fhe <br /> work lor which applicahon is made and I comply�rifh the State Confractors Lew 18.27 RCW and <br /> 29G.200 l4�AC. <br /> ,, ; " <br /> ? // , � <br /> � %�/ .�i'� lj <br /> !- � �- "� �J <br /> sic7nalure oate n ! <br /> � � 5 <br /> �� <br />