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ELECTRICAL PEl�MIT APPLiCAYION <br /> CITY OF EVERETT PERMlT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE�CCEPTED FROM 8 AM TO 4 PM <br /> � GL' ,:}� �� - l/"�< fl /1 �.J�/ ���r' �vC.-/. ��1� /�/�A `�'�j'���, J <br /> G % <br /> PROJECT ADDRESS <br /> �/�- S � <br /> �'�'C�_/�� ��% '�I�%/(J /fi�`) Jfi��x;�i �vf ;'c°// `!i,C' i'OcG J G i`_i <br /> Owne � Idail Address City Slate'Zip Phone <br /> Tenant �dail Addrnss City Slale/Zip Phenc <br /> /"I <br /> � � <br /> �-''�, ��� /�' E�� <br /> Electrical Conlrac�or htail Address City Stale/Zip Pnone <br /> State License Number Conlracl Price of N�orl: <br /> Proposed Use ol Building Contacl Person (Plan Review) <br /> i / / <br /> Description ot Work lo Oc Gunc. 1��i/�`h"J�i:' ^✓�f lr��ii'�'r/q ��J r<•��A� i'r/l <br /> �F '✓i/ iJ�/Ci � 'ICii..ri/�! �I- �NA/L-/ � l"1(t' J <br /> i�7—�� <br /> NOT[: WIRING IN NON-DWELLING3 IS REQUIRED TO FEE <br /> BE IN RkCEWAYS, MC OR AC CABLE. <br /> I CITY OF EVERE77 LOCAL SALES TAX CODE IS 3105 <br /> ;4 1 hereby cenily that I havc read and examined this ap��lia�tion and kno�r!he sarue to be f�uo and <br /> corrocL All prov�siens ollaws and ordinances governmo this fype o/work �rill Ue compleled <br /> trhefher speciGed hercin or noL The granting o(a pennrt does not nesume to gi��e e�ufhorty fo <br /> violate or cancel fhe�rovisions o/an}�ofher stafe er loa�l laH rec�ulating consWchon or tlre /l}Z� <br /> pe�formance o(consfruction. Thaf I am authorized b}�the ota'rte�o/fhis property fo perlonn fhe � � <br /> �rork lor a�hich applicafion is rnade and 1 conrpl}�irifh fhe Sfate Confraclors Lair 1827 RCIN an.� ''h� <br /> 296.200 WAC. �� <br /> l , � %� <br /> � j � V <br /> � �-� ,�i7 : � �,, <br /> ��i1��- ' . ,-�/17�%� • . . -1 <br /> ,�S`iyno�ire �--�� Uate <br /> � � <br />