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ELECTRIGAL PERMI� APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9820'I )I —G�� <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org E 06�, -oaq <br /> APPLICATIONS ARE AC!:EPTED FROM 8 AM TO 4 PM <br /> /� �� �cr�;�.�-��;) y�3. <br /> PROJECT ADDRESS �J��` <br /> �/ �( <br /> fL � �t IA,((�= l�'DI�E�' �yll �nMl3;�/Ll9 �C�% ��.�/ <br /> Owner Mail Address City Slale2ip Phone <br /> Tenanl Mail Address Cily Stale/Zip l/�S Phone <br /> 7 <br /> ��L.y} NIJk'!iI S l�S ��0 1 �V �l/ �l/ /�-''6/ �/ � %6/ <br /> Eleclrical ConUactor Mail Address City Slate/Zip Phone <br /> r��,� �, sf i y z � N <br /> Slale License Number Conlract Price o(Work <br /> S FjL <br /> Proposed Use of Building Contact Person (Plan Review) <br /> DescriptionoFWorktoDeDone: ���1� ����'C^ �Z�Lr�� /M�x! Q�� fjC�Z(�lC� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ��d� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify Ihaf 1 have read and examined this applicafion end know the sarne to 6e true and <br /> correcL All provisions olla�vs and ordinances governing fhis type ol work will be complefed <br /> whether specified herein or noL The granfing o/a permd does nof resume fo give aufhonty fo <br /> violate or cancel the provisions oI any othersfate or local faw reguPfing consfructwn or Ihe <br /> perfonnance oI construclion. Thc�t I arn aulhorized b}�Ihe owner of this propeRy to perfumi fhe <br /> work lor which application is made and I compty with fhe Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. (` <br /> . <br /> n �� <br /> � � � <br /> / <br /> ,�"� '�l '�/ l//l>Ci/�G �� � - <br /> /Signature Date � <br />