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ELECTRICAL PERMIT APPLICATaON <br /> CITY OF EVERETT F'ERMIT SERV�CES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 47_5-257-8857 - www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � l C /.� ,�; J.'�r� i/ �✓.�. <br /> PROJECT ADDRESS <br /> i / � �9 �i- <br /> '1G� <br /> jc' /�� I `�'s�"li ���'=� l. 0�'ll�r:/ � �r��f i vi /��: ' �il� �li '�� y%-O �/�J� <br /> Owner � Mail Address Ciry State/Zip Phone <br /> Tenanl Mail Address Cily Slate2ip Phone <br /> �")i�{ l/ /-/�P'LJr', iy 1 'i/ i��� /Ja�/ �G y � G�(//1/9LG��� (,c���/l`lf��J� 1�5 y�✓Dr� <br /> EleClrical Contraclor ' htail Address City State2ip Phone <br /> � <br /> i <br /> �o%E 'f c!�;/) i�f�l' <br /> State Lice se Number v Conlracl Price of Work <br /> �i?<<,r /1,����, <br /> Proposed Use of�uilding Contacl Person (Plan Review) <br /> � /� I <br /> Descriplion of Work to Bo Done: ��E u�r /� = ��i c�c !14 iJ �" ���-'!/1� rI �' ��� ��r �'� �' /�. �Lr,' ' <br /> _/� r ,�( ' <br /> IJ , <br /> [�C�Y VG' I 6�< YI ['R/�jC � :F� � �1�Y.:�/R (Y- /�� vI. �J ✓G�: C F�' CG{ �� �U <br /> (� ('�Y / J i LC r�-S� � Lt/��. ,��:�r/� . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQU!RED TO FEt <br /> BE IN RACEWAYS, MC OR AC ('ABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhat I have read and examined fhis application and know fhe same to be true and <br /> correct All provisions o//a�vs and ordinances go��ermng this type of�vork �vill be cernplefed <br /> whether specified hcrein or noL The granting o/a permd does nof presinne lo give authonty lo <br /> violate or cancel the provisions olany oGiei state or,ocal law regulatinq cons�rucGon or the <br /> pe�formance ol construction. That I am authorized by fhe owner o/fhis property to perlunn the <br /> work for which applicalion is made and I comply with the Sta(e Confracfors Law 1827 RCW and <br /> 296.200 WAC. �, <br /> �t%`�1�� /��� 5 ��/� `;i <br /> SignaWre �'� Dat <br /> , 1 �l`T�/J'Cl�� <br /> _ __._ _ _. .. __---- r -- <br />