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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �(j � � 3'�6 <br /> 425-257-8810 - FAX425-257-8857-www.everettwa.org �o6ip _1 "rJ3 <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> �/O�� GO��,ni��P_Rc � i4 �- <br /> PROJECT ADDRESS <br /> c <br /> �t' �J��>���� /_7(J['P �l ��/ C«1,.� ,.. ;� � . ,><. (���/',�ll /d�Z0.Y�S <br /> Owner Mail Address City Slate/Zip Phone <br /> S/�Y'/�19 t. <br /> Tenant Mail Address City Stale2ip Phoae <br /> i�,��� .�� �-� <_ i �/�ro� ;`;-s i s- �,,1 n^�,�;c,z�o �,..q ir?� 7,— <br /> Electrical Conlractor Mail Address City State2p Phone <br /> �r-�r,� � �,� 9S�/ R 9 35�v — <br /> S�alo License Number� Contracl Price of Work <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> Descripfion of Work lo Be Done: �C�� r�i/I ,� f?� /'L,.�oDc'L <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 /> 1 here6y certily that 1 have read and examined fhis applica(ion and kno�v fhe same to be tn�e and <br /> conecf. All provisions ollaws and ortiinances govemmy fhis type o(work will be completed G C1�l(� ' ��J 3 <br /> whether speafied herein or noL The granting ol a perrnd does nofl�resume to give authonty to <br /> vinla(e or cancel fhe provisions ol any other state or Iocel Iaw regu afing corrstrucfion or the <br /> per(onnance oI conslruction. That 1 am aidhonzed by fhe owner ol this property to perlorm fhe <br /> work/or which applicafion is made and 1 comply with fhe Sfate Contracfors Law 1 B.27 RCW and <br /> 296.200 WAC. <br /> -�� <br /> t.-'vi / --e�.�_ ._ �(� " Z�J � <br /> /SipnaWre � Date <br /> l.' <br />