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f <br /> ELEf�TRIC�►L PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 Y � � ��� <br /> 425-257-8810 - FAX 425-257-SJ57 —www.everettwa.org <br /> Cnboy..a�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �'�j � C�"�1►�)��I'cic � 11C�� _ <br /> PROJECT ADDRESS `��y�C>3 C�Il) �IG' E�y'3 <br /> ��(��1`�1- l�t�l C�� I C� ����'-I l C�f�'�cin��r� I��f!-���—rc 1�r ��. <br /> Ownef M1tailAddress City � StatelZipt��,�C�� Phone <br /> Te� � Mail Address City State/Zip Phone <br /> �'0 P �lcc��c -�nc Pn �� �cx�3 �11�c1 � � �VA� �i£'oy� (�rz��-- `r�tz <br /> ElecVical Conlractor ail Address City State/Zip Phone <br /> I��e�z-�oy�� D r � «�o�� ��, <br /> Slate Licsnse Number (:ontracl Price of Work <br /> � , � (-� � � �� ��lr►� f-�� I � <br /> o�Us��ilding ` JI� �IM1 1 Contac� tPerson(PlanRevie�v) <br /> Descriplion o(Work to Be Done: �{� �C !/�l C A �' � ����C ` 1 � I1 Ct � ��� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE �N RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE�S 3105 <br /> 1 hereby certily fhat 1 have read and examinad this applicatiun and knav the same to be true and <br /> correcL All provisions o!lows a��d ordinances govermng this type ol work will bN completed <br /> whelher speci(ed herein or nof. The c�ranting o(a perrnd does not presume to give authonty to <br /> violate or cancel fhe provisions of any other sfale or local law regulafing construcfion or the <br /> pe�fomiance o/construction. That 1 am�ufi�orized by fhe owner of this property fo peAorm Ihe <br /> work for which application is made and 1 comply wifh Ihe Sfafe Contractors Law 18.27 RCLN and <br /> 296.200 WAC. <br /> �l �.C..� �IIN �Oh � � <br /> Si nawre Dat � � � <br /> �_ �' � <br /> ✓ <br />