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EL�CTRICAL. PERMIT APPLICAT'ION <br /> C�TY 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 � � s -B <br /> � �,- - l: � �=r�,�7�?� ��� Jl: t� /� ;� �( <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> '��-'��� � � �����1./l'� <br /> Tenant Mail Address Cily Stale/Zip Phone <br /> �� C � i'! - ) C7C C c � [ �' . . c,� <br /> ' I� � / J F"� `1 � �•� L �2 /�L l �7 KL`�,i. /-IZ'�c�C L .f /:,C 2_ c It`� (,,J_ CS - <br /> EleclriCal ConlfaClor �tail Address Cily Slate/Zip Phone <br /> � <br /> / �)c.' :. �� - � � _, /��., <br /> �4 ! ��_> � ''--� --�C C' f<'�- �� � <br /> Slale License Number Contract Price of`Nork <br /> �, — � <br /> 1 � i ,� : � C_ �E-. �,� <br /> L i ' � ,�1;' �c: �< < �, <br /> Proposed Use of 9uildin9 Contacl Person (Plan Review) <br /> � \ <br /> Descriplion o(Work to Bc Done: l\C� �� ���% ��- (� / � S f:i"� <br /> �' NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> II CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that 1 have read and examined this application and I<now fhe same to be true and <br /> correcL All provisions o(laws and ordinances�ovemmg this type o(work wiil be complefed <br /> whether speciGed herein or not The�ranting of a pernut does not presume fo give aufhcnty to <br /> violate or cancel fhe provisions oiany oUier sfate or local law reyulafing construch�n or the <br /> peAormance o/cons(ruction. That 1�m aufhorized b}�the c�vner ol fhis property to perform fhe <br /> work/or which application is made and I comply�vifh(he State CaVractors Law 18.27 RCW and <br /> 296200 WAC. <br /> (/ � ` r / <br /> ,/ �/ �'�• ` `�- `�-'6 �l ��i L �b <br /> Signature Dale <br /> Eu� i � -c�t 'J <br />