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ELEC�RICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.evereltwa.org ���D�b j <br /> APP°ICATIONS ARE ACCEPTED FROM 8 f�M TO 4 PM C t770�'O� <br /> 5ic � �o G,�-���� �i v h � 3 3� c� <br /> PROJECT ADDRESS � s .3 <br /> � y�G�s <br /> �,�9 I � . �� C•' cX ��`� /�1 hlZ4�p /C.G,�ti f�� l�� <br /> Ownaf A1ail Address City State/Zip Phone <br /> T��nant A1ail Address City SlalefZip ��� Phone <br /> ��'l-✓1-Nl�i�6� 1rs 34�/ ��/ /�f/ !�(/ `�'���/ �y ,�ll� / <br /> EleCtric2� Contraclor Mail Addmss Cily Stale/2ip Phone <br /> �Y�.► �ss � y z � i� �Sd "= <br /> Stale License Number Contract Price of Work <br /> /4/'T v M I� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description of Work lo Be Done: �,��!L 1 / � � ��[ i,��j �`U � Q% � //�1� /�J�7 <br /> �. r��r x r�,e.r N-� <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �� G`� <br /> . <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerfily thaf I have read and examined fhis application and kno�t�fl,e same fo be true and �L � � �f t' �l � U� r <br /> correcL All provisions ollaws and ordinances govemmg Ihis type o/�vo�k �vill 6e completed <br /> �vhefher specilied herein or noL The granting ol a permd does not p�esume to give aufhonty to <br /> violate or cancel fhe provisions o/any ofher stafe or local law regulatiny consfruction or the <br /> perlormance olconstruction. Thaf 1 am aufhorized by the onvier o/this property to perlonn fhe <br /> work 1or which applicafion is made and 1 cornply�vifh Ihe Sfafe Contracfors Law 18.27 RCW and � <br /> 296.200 WAC. � , � <br /> > <br /> ' � �-L�, �' /c � � ' ' <br /> Signature Date <br /> � <br />