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ELECTRIC/s►L PERM�T APPLICAYION <br /> CITY OF E1/ERETT PERMIT SERVICES <br /> 3200 CEC�AR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTEG FROM 8 AM TO 4 PM <br /> /O�Q S� � Je2�� /�N� Ll W � /Sfe � tJ2J / �l�y �. <br /> PP.OJECT ADDRESS � <br /> Owner Mail Address City State/Zip Phone <br /> ��e��e I-�•9 ra�i ��'r� <br /> Tenanl Mail Address City State2ip Phone <br /> �sy,��,, ,�J1 E 1�.,��. .�J, �3x �-�� S�a��.h,-s� �r S�'15� �/z 5� 3 - a:� <br /> Eleclrical Conlraclor Mail Address City StatelZip Phone <br /> Q / GC.� <br /> / 1 S S�l L L.�: � ,Sti l.� � F�.S� -� <br /> State License Numbcr Conlrecl�flrice u(Work <br /> J � �tJ'C <br /> Proposed Use of Building Conlacl Person ;Plan Reviea�) <br /> � <br /> Descriplion ot Work lo Be Done: '�i.✓r ���•'`r� L� k'1.J � /W 1� NP 4.1 <br /> � � <br /> (`,u /{t.�.� <br /> NOTE: WIRING IN NON-DW�LLINGS IS REQUIRED TO FEE <br /> i <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> li � <br /> � <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � 1 hcreby certily fhat I have read and examinea fhis application and know the same to 6e true and <br /> coi�ecl. .11I provisions o(la�vs and ordinances governing this type o(work wil/he co,^ipleted <br /> ( �sliether spec�Ged herein or noL Th�g�anting ola pernut does nof presume tn give aulhonty to <br /> violafe ar cancel fhe provisions ol any other slate or local la�v regWating construction or the <br /> peifennance o/construcf�on. Thaf I am authorized by the owner o/fhis property to per�orm the <br /> �rerl�!or which applicafion is made and I romply with(he Sfale Gontracrors Law �8.27 RCW and <br /> 295.200 WAC. <br /> � <br /> � � <br /> �� .,,,�c �;�cti � (� �ji?�%v �� <br /> � <br /> SignaWre Date <br /> ����b '(�� <br /> I <br /> �-- — <br />