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i <br /> 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 /> � irll E�C�Ic=� �-�c'�= <br /> PROJECT ADDRESS <br /> p�� �'i0 I=�-�,�uz"[c_ <br /> Owner h1ail Address City Slale/Zip Phone <br /> (r'_ 2 n -7�I � <br /> Tenanl Mail Addrese City Slale/Zip Phene <br /> C^T"�%ti'iTC �C�GT/zIC' f D t�C 29G1� E/F'•C�-7T GtJL4 9��Z13 <br /> Elecirical Contrac�or Mait Address Cily S:ale/Zip Phone <br /> CYY'`i%"�/ IC C%/-{FJIL'IG l ��"��-L �"IC� S l� � <br /> State Ucense Number Contracl Price of Work <br /> C ��% �i�wi��i»��sio� <br /> Proposed Use of Building Conlact Parson (Plan Review) <br /> � - / � <br /> Description ol Work lo Ba Donc: '�— /��y j�l�v h�7/�Cl� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � <br /> l/C � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 he�ehy ceriily fh�l 1 have read and extunined fhis npplicalion ond know fhe sarne to be truo and <br /> correcf. All provisions ollaws and ordinnr�ces goveminy fhis type o!rrork will be completed <br /> wheUier specd�ed 6erein or noL The granlin�o!a pemut does notl�iesume fo gi�o aufhonty fo <br /> violate or cance/Ihe provisions of any ofher sfafe or local la:v regu afing cons Wchon or fhe <br /> peAomiance oI construcfion. That 1 am authonzed by fho owner o!fhis�roperty fo perfomt the <br /> u�ork lor which applicotion is mado and 1 eornply with fhe Sfafe Controclors Law 18.27 RCW and <br /> 29G.200 WAC. <br /> - -� i� -�/�:� /,� �� � �� a <br /> , .�<<., � _-�-- � � <br /> Siclnulwe D�le <br />