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ELECTRICAL PE�MIT APPLICATIC3N <br /> CITY 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 G ` -��_�� <br /> -- � D 7D ���33 <br /> �'>,`�=�-� �(';�v�����C� ��C� <br /> PROJECT ADDRESS <br /> � Ci�C( �l �.��f1S-I�i LtC ���,r1 ����nY�n�, �I �l��r�r� lv(1 �i�a�nil <br /> Owner Mail Address Ciry State2ip Phone <br /> Tenanl Mail Address City State/Zip Phone <br /> UZ�� <br /> `�umn-���- �t 1�r 1� ��c �nc �C��Gt�1��v(�(� W A �iRa�l a ��(:��5r1�`; <br /> Eleclrical Conlractor Mail Address City Slate/Zip Phone <br /> ���rnml EIC�( ��;}: 7- <br /> Stale License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description af Work to Be Done: �� Iti1�] C�ttA L r — ��f I��T <br /> � �� <br />( <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> j BE IN RACEWAYS, MC OR AC CABLE. <br /> i � <br /> � <br /> CITY OF EVERETT LO�AL SALES TAX CODE IS 3106 <br /> �,I 1 hereby certily that 1 have read and examined this appfcafion and know the same to be Vue and <br /> correcL All provisions ollaws and o�dinances governmg this type oI work will be completed <br /> �vhether speaGed herein or not The granting o(a pernut does nof presume to give authority to <br /> ��I violafe or cancel fhe provisions of any other stafe or local law regulating constiuc6on or fhe <br /> peAomiance oI consVuc:�on. That I am aufhorized by the owner ollhis property to oerlorm the <br /> � work lor which applicalion is made and I canply�vrth the Stafe Contractors La�v 1817 RCW and <br /> I 296.200 WAC. <br /> �_)�CXk���U�����r ;�� �i1 ���1���1 <br /> SignaWre Date <br /> I <br /> i <br /> I I <br />