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ELECTR.ICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 g`�� �d 7 <br /> 425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C D�70 �—IO� <br /> ! ' •" �� � -� � <br /> r�� � % /�. . „ _ �I <br /> PROJECT ADDRESS <br /> .�..,-. ;y3 <br /> il IG��.�l�'e�,. .i Jl"ti �." L��� yil��( •1 lI( I`/ /..°;:��';�i,� �G'nt� � ( �A c:�?�- /� � s�� > <br /> Ownef Aiail Address Clly State/Zip Phone <br /> Tenanl Mail Addross Ciry Stale/Zip Phone <br /> �jLT -Z �7 <br /> �Y��„/r. .5t ;.; �5�'�c- ��C�/ �i'rb�. �r �c�..�71 c'� . 7 �'�LG / z /!/ <br /> ElectricalConlractor MailAddress Ciry SWIe2ip Phone <br /> �= S'��ti�� s r �>L � �' � � o�'�° `� <br /> State Licenso Number Conlract Price of Work <br /> /' <br /> /j Ni; — <br /> Proposed Use of Buildiny Contacl Person (Plan Revievq <br /> Description of Work to �e Done: C c`:�v r'�� j� c h � �r � � f!iI^H 4 L� �' �, ���t: ,,�� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRELI TO FEE <br /> BE IN RACEWAYS, MC Ok AC CABLE. <br /> �, I <br /> i CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y certily fliat I have read and examined this application and kno�v the same fo be frue evnd <br /> correct. All provisions ollaws and ordinances govemmg this type ol work�vil!be complefed <br /> whefher speci(ed herein ornoL The granfing o/a perntd does nof presume to give au�honf}�(o <br /> violate or cancel the provisions ol any ofher stafe or local law regulafin�construction er the <br /> perlom�ance o/conslrucfion. Thet 1 am aufhonzed by the o�rner o/fhis piope,dy b pedum the <br /> work lor which application is made and 1 cornply�vith fhe Stafe Confracfors La�v 78.27 RCW and <br /> 296.200 WAG � <br /> � <br /> / - /� ) <br /> ,✓� �%�' i'�7� �-i��- � ' � � �, �; <br /> Sic�na ure Date <br /> � <br />