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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 4 ���`D� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org �,�0 b v(.�.,��� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �"/ ] y ��7f11/L�/j����t��� �./L . <br /> PROJECT ADDRESS <br /> ,LJ��� /�'/��� `T�� y C°��N�c�ti' �l�es�Ji— /d 2U�' Z�Z 70 � <br /> Owner Mail Address Ciry SWte2ip Phone <br /> Tenanl Mail Address Cily SlalelZip Phone <br /> J�i�-�l /L'�/L�f� <br /> Eleclrical Conlraclor Mail Address City StalelZip Phone <br /> ,'',1�,�- r Z ��9/,�fi� . �3 v o <br /> Stale License Num r Conlract Price of rk <br /> ���t'C�l9�C���?!1 <br /> Pro�osed Us o(Building Contact Person (Plan Revietiv) <br /> Descriplion ol Work to Be Done: �J9 9 ��'(rr� ���� �� �'1�CJ i�(CL,�S��?/1 !'/�c7 �'7'� <br /> ,J� � <br /> �f'�� I�l9r;t � <br /> �� <br /> I <br /> NOTE: WIRING IN NON-�WELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX COUE IS 3105 <br /> 1 here�y certi/y that 1 have read and examined this application and know fhe same to be true and <br /> conect. All provisions olla�vs and ordinances c�oveming fhis fype ol�vo�k will be completed <br /> whefher specilied herein or noL The granting o/a pennrt does not reswne to give authonty to <br /> violale or cancel the provisions o/any ofher sfate or locallaw�eguPting construction or the <br /> peAonnance o/consfrucfion. That 1 am authorized by the o�vner of this prope,ny to pedorm fhe <br /> work(er which application is made and I comply�vith fhe Sfafe Contracrors Law 18.27 RCW and <br /> 296.200 WAC. � <br /> �� <br /> ��i''� `/j/ L/., <br /> / %��i� ��// / ` / � — ��`-'" . <br /> Si ur�— Dale . <br /> l�Ck���v <br />