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ELECTRICAL PERMIT APPLICATIC�N <br /> CITY OF EVERET7' PERMIT SERVICES <br /> 3200 CEDAR STREE T, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 - v,n�✓w.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I`11 ? I �; �� �,. � �) l�� - ��_ v� �� i� +� w r� y �z� f <br /> ?ROJECT ADDRFSS <br /> `I `�SZ� ( <br /> —��J ) ��ct X�-� � � `� � / �-n v�n ��� ✓� �� Il� � �/�_✓�i-+; l�f� ��LS� � <br /> Owner A7ail Address Cily Stale/Zip Phone � <br /> �� <br /> � J � 1 I�d�� l � �/ 1 � Ln v�n �7u J'����-� .��/c r .�"I"-�--�! � I ��O � y Z�ZSt � /.��� <br /> Tenant Mail Address City Stale/Zip Phone C�(j� <br /> Eleclric �.I Contraclor n W �h1a Address City StaterZip Phone <br /> Stale License Number Contract Price of Work <br /> Proposed Usc ot&�ilding Contact Person (Plan Revie�v) <br /> C � r � <br /> Description o(Work to Be Done: � � '� � E L�C�—C � +�C� 6���� �-o� <br /> NOTE: WIRING IN NON-DINELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> II � <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � I hereby ceriily thaf I have read and examined this application and kno�v the same to be true and <br /> conecL All provisions o(laws and ordinances goveming thrs fype ol work�rill be cor�plefed <br /> whefher speciGed herein or not The r�ranfing o/a permd does nol resume fo give authonty to <br /> violafe or cancel fhe provisions o�any other state orlocal fa�v rer�uPting consVucfion or the <br /> perlormance oI constr�cGon. Thaf i am aidhorized by fhe ou�ner o�this propeRy to perlorm the <br /> worlc lor�vhich applicafion is rnade and I comply with the Stafe Confracfors Law �8.2i RCW and <br /> 29G 200 WAC. <br /> �/ � ��/ ' / <br /> Signalure Uate <br /> �, �-p4oy -o� � <br />