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ELECTRICAL PERMIT ,APPLICATION <br /> CITY flF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREIT, WA 98201 �., �j,� —Q 7 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org C O70�l`-��d <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � J � ( � � �Efifi , �� ��?1�`�' <br /> PROJECT ADDRESS <br /> 1-���3�cD-�2 � l <br /> n Letl��S,�"7Li <br /> V'���i � ' �F�n IG�1�� �}-�r`� fl�e� �i�u{��m�'S1� �A ��yc� <br /> Owne� MailAddress City Slate/Zip �j82 i0 Phonc <br /> Tenanl C1ail Address City Stole/Zip Phone <br /> �—�%�l C� l <br /> Electrical CoNractor P.1ail AJdress City Slate/Zip Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Buildin� Conlacl Person (Plan Review) <br /> Descriplion of Work to Be Done: ��`� P� ��J I��UJ�. �T I � (�m {� <br /> l ('�CC�i_T I �� I iJ Ill �`P V A f j � � (L�i � � � (71 A.��.. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FE[ <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhat I have read and exami�red this application and know fhe same fo be true and �.�;-�L C�-\��1.^ <br /> correcL All provisions ollaws and ordinances govermng this type ol v✓ork will be complete� <br /> �vhefher specilied herein or not The granfin[�o/a perrnrt does notp resume fo give aulhonry tu <br /> violate or cancel fhe provisions oI any o(her sfate or loca/la�v regula(ing construction or the <br /> pedormance o/construcfion. That I am authorized by fhe owner o/this property to perforrn the <br /> work lor which application is made and I comply wifh Ihe Sfale Contracfors Law 18.27 RC W and <br /> 296.200 WAC. <br /> � � <br /> i ��, �2�/�c� 7 <br /> I -�Sign u a Date <br /> 1� <br />