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ELECTRI�AL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � <br /> 425-257-8810 - FAX 425-257-8857 —v,�ww.everettwa.ory ��(� —O <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C�gog-�a3 <br /> � ,•� - il � � . j�„- c � . -- �;;'.�)L,i� 7l �'jJ/�� , <br /> 1 ! , <br /> PROJECT ADDRESS <br /> c'� �> - <br /> :��n, ( .,� � - �,=4 : .- r !��;>:, i' �ii,=� � ,� � �'� �36d GSs- 1 .,; � <br /> f " <br /> Owner 61ai1 Address Cdy Slate/Zip Phone <br /> Tenanl Mail Address Cily SlatelZip Phnne <br /> � � f�1T'Ul�� � � cr ��'i f�� ����' f'�/t"r'Si �l�t� �('l� ��Q1TC; ��l�S�v"TG /3-✓� � <br /> Eleclrical Conlraclof A9ail Address Cily Slate/Zip Phone � <br /> f�' �rUiUe�- �16`1 I�l� �) .� SC�) . C'�� I <br /> Slafe�License umber ContraclPriceofWork � <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> �� i <br /> -1 � �-I I-1 ����lU:�7 f�C"���... <br /> Descri�:lion e�VJorh to 6e Done: � ��-�� !� ��'+�- �` � <br /> NOTE: WIRING IN NON-DVVELLINGS IS REQUIRED TO FEE <br /> i BE IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> lliereby certily fhat I have read and examined Ihis application and know the same fo be hue and <br /> conecL All provisions ullaws and ordinances 9overnmg fhrs type ol work will be complefed <br /> �rhelher speci/ied herein or noL The granlinc�o(a perrnd does nof resume to give authority to <br /> violafe or cancel the provisions ol any ofher sfafe or local la�v re�uPeing construc6on or the <br /> perforrnance o(construcfion. That 1 am authorized by the o�vner ol this property fo pe�fornt the <br /> v.•ork Ior which application is made and I comply wifh fhe Stafe Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> _��.`-�- " _ �,:c,/_ �. ,_;. <br /> , , Sic�naWre Da1e <br /> G OB�'��3 <br /> � - - -- _ _ _ <br /> _ _ _ _ -- - --- _- <br />