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ELECTRI�AL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICf�S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 –www.everett�va.org <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO�S PM <br /> r / <br /> � � I I _���� h �� ��� � ,I ,;��, <br /> PROJECT ADDRESS <br /> �,ribi� /' ;�' f�'I% /;'%/ C_� ),,.1'X�, c� ;���' < � � �� i�`%/ [_�'i� 1�����% <br /> Owner Mail Address Ciry State/Zip . Phone <br /> — `�>j��S Z -a%:c,� <br /> Tenanl M11ail Address City Slate2ip Phone <br /> Eleclrical Conlraclor Mail Address Ci�y SlatelZip Phone <br /> Stale License Number Conirect Price of Work <br /> ;�����,ti� t� i,�1 >�- — <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work lo Be Done: �'��� ��� �L' ���`���� L}L�'� <br /> 1� � <br /> � i ._� lx'k � {�\C`�F)' �� ��t.i Li-C��S��l� c�� <br /> I�( / — <br /> i � \f <br /> � � �, ._ � , <br /> NOTE: WIRING IN NON-DWELLINGS iS REQUIRED TO FEE <br /> BE IN RAGEWAYS, MC OR AC CABLE. <br /> i <br /> CITY OF EVERETi LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi(y Ihat 1 have read and exarnined fhis application and know the sante to he frue and <br /> correct. All provisions ollaws and ordinances govemmg this type of worR will be completed <br /> whefher speci�ied herein or noL The granting ol a pemnt does not resume to giv�au(honty(o <br /> violate or cancel the provisions olany olher stafe or local law reguPfing construction or the <br /> peAormance oI consVucUon. That I am authorized by the oa�ner o/fhis properiy to peilonn fhe <br /> work Ior which applicafion is made and 1 compty wifh(he State Contractors La�v 18.27 RCIN and <br /> 296.200 WAC. <br /> __ � �_. ; <br /> � <br /> , _ . .__ L . ���i.., -�, % <br /> Signatwe Date <br /> � C ?O7 `G7�I <br />