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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> --' ZC 5 C�a-fv�+-ts,.v� W�-� <br /> PROJECT ADDRESS T <br /> r��� e E �����'�t-t— <br /> Owner Mail Addross — <br /> City Slale/7JP Phone <br /> �.. <br /> 5r_�, f-ll-:� Io�� �-�- ��re���✓ic/ <br /> Tenant ` <br /> Matl Adaress Cif - <br /> Y Statc/Zip Phone� <br /> ) r I � <br /> �f �l�fnP L`� ��rlLc..! �t rU��cf'� � G �� ��! � nt�t � ��`� � f � Z > � <br /> ElectncalConiraclor MailAddress Cdy State2ip Phone <br /> /��,�� ne l �i,�/ �5,��.�c.� <br /> Stale Icenso Number Contract Prico of Work <br /> � � /•- r <br /> y r'7����•_��11 I�'c� � <br /> Proposed Use oi Buildfnc� Conlact Person (Plan Review) <br /> Descriplion of Work�o Bo Dona: <� � � ,� J�� <br /> !i�i � �� L LJ� {1`��' u�} cf cS El^�(f7 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. • <br /> CI7Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ce�lily fhaf I havo rend and exomined(his appfica(ion and kno�r fhe samu w bo truo and <br /> correcf. Al!provisions oI/aws mtd ordinaac�s govemmp fhis type e/�rcrJ� will bo complefed <br /> whefher spocilled harein or not Tho�ra��fing ol a penn�t does not �resumo to glva nuthonty(o <br /> viola(o orcancel fhe Provlsions ol any oHiei sfafo orlocnllnwregulatinp tonsfrucfion orfho /J <br /> per/om�ance o/construction. That I om eufhodzed by tho owner o!fhis property fo porfom�fhe "/ <br /> work!or which appllcallon!s made and I comply wifh fho Stafe Contrac(ois Lmv 18.27 RCW ond C Z 6 <br /> 296.200 WAC. � <br /> /' /IG �( <br /> ;- � / <br /> , � ;,,. , , , � <br /> ;� . � , ri / <br /> "_ � �iy��at��re _ . — f . <br /> Uate <br />�r <br />