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ELECTRICAL PE�MIT APPLICAi'ION <br /> CITY O� EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, CVERETT, WA 98201 � <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org 3-�� 9 <br /> APPLICATIONS ARE ACCEPTED FROM 8�.A1 'O 4 PM �'�O�d 3-�� <br /> i �) <br /> � � Y���� � /! �C� L�'n � <br /> PROJECT ADDRESS <br /> / �-, � <br /> L- ��� �,� r� ��,n , ti�t � y��s' �����, 1,�,��� E,h�d � l�'� � �� o � <br /> Owner v h1ail Address City Sta1e/Zip Phone <br /> Tenant Idail Address City Stale2ip Phone <br /> I , \�� I II ^ /� / // /I /y'�/ �j <br /> ///l,� �11. \ �l � f�'l,l� U'7Z �( �?JCId �//1P/ �i. �i��nd ``/G `IZJC�7��}Ld�SS/�'�li�Z <br /> Eleclrical Conlraclor Mail Address � City ite2p Phone <br /> � Sz,� . �,� <br /> �L�,,, �n x.��,9 w v <br /> Slate License Number Contract Pnce of Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description of Work lo Be Done: P'G "-<< N� V-2fC �\o � Z�D A- <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 her�b��certily fhat 1 have read and examined fhis applicafion and know the sarne fo be true and <br /> correct. All provisions ollaws and ordinances goverrung this type o/n�ork will be cornpleted <br /> whefhe;specdied herein ornot The granfing o/a pernut does not �resume to give aufhonry to <br /> violate or cancel the provisions ol an}�ofher state or local la�v regu�itin�consWcUon or the <br /> pedormance ol construction. That 1 am authorized by fhe owner o/this Uroperty to peAorm fhe <br /> work lor which applicafion is made and I cornply wifh the State Contractors Lan� 78.27 RCW and <br /> 296.200 WAC. <br /> � , <br /> i' <br /> r <br /> ':� ---�_ -- 3 2�= . p �� <br /> � igna Date -� <br /> �z _ �,�, <br />