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ELECTRICAL PERMIT APPLICATtON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, E VERETT, WA 98201 <br /> 425-257-8810 - FfJC 425-25i-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � I� ' ) <br /> � �-1 �IP�'_11 l �'�`- `� a-� <br /> PROJECYADDRESS � <br /> `� � s , �,1= � �n�� �����.�c� ��� �5 <br /> �- �� -I��r��(�5�,-� i�,o� r1 ;� ,,, <br /> OwOOf Meil Atldress Ciry Slate/Lp Phone <br /> Tenant MailACdress Ciry State2ip Phone <br /> �-11�-8YS-hl ?� <br /> `-�C�n i�SSCC� ��S 1��' 6$LS l�U�' P�C ��Ly��n (�? ��51. <br /> Eledrica!Con�fadof Meil Address Ciry Staletip Phoce <br /> ( ���' <br /> ��l G�/1 Fi''r k 060�b <br /> State License Numhcr Contrect Pnce of Work <br /> �� <br /> Proposed e of Building Contact Person (Plan Review) <br /> oescnption ot Work;o Be Done: � C'�r�� \2� Gne'�I ('�C��P� "���� <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 hereby certily that 1 have read and examined this applicalion and know the same to be true antl <br /> conecl. All p(ovisions o/laws and ordinances govemmg this type o/work will 6e complefed <br /> �vhcther spaa(eJ herain or nof. The grnnting o/a pemut does not presume to give aufhonty fo <br /> violate or cancr.l theprovisions of any other state o�lucnl law repuleting construdion or the <br /> perloRnance of conshuction. The�I am authonzed 6y tha owner ol this pro�eRy fo pnAonn�he <br /> work-for which application is made and I comply wifh the State Contractcrs�aw 18.27 RCIN ard <br /> ,�296.20 I�VAC. <br /> , .I�� I`1_ ' J t�� <br /> �' iq ature Date <br /> � <br /> .�5/z�-11 y <br />