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ELECTRICAL PERMI�" APPLICATIUN <br /> (;ITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STR�ET, EVERETT, WA 98201 <br /> 4?5-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PR JECTADD ESS uJ�-/ I�IryCC I <br /> r. ^ <br /> �� <br /> •c�"-�-'X'i� i 11 L CL�b�i i �i_`< /<���U <br /> Own� �dail Address City Slate/Zip Phone <br /> I <br /> Tenanl Idail Hddress Cily State/Zip Phcne � <br /> �'2� �� � � ��C �,�� ��(��5� � � �c..>e2e l J �-�1�bg ��J 3�r1�� S ���� <br /> Eleclrical Coniraclor Matl Address City State2ip Phone '. <br /> F-��,�a,�,a � ° ( l3f�;� <br /> Stale License Number Conlract Price of Work <br /> � ( (/� <br /> I ��'Vl./� /"�W�2 I'�C' � ' <br /> Pwpnsed Us of 13uilding Contacl Person (Plan Review) � <br /> Descriplion of Work�o Be Done: � r -'Y���,`J l�� �� �, <br /> i I <br /> 1 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE I <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> I <br /> �I GTY OF EVERETT LOCAL SALES TAX CQDE IS 3105 <br /> L <br /> � I he:reby certily fhat 1 havc read and examiired this application and know fhe same fo be frue and <br /> �I correct. All provisions ol lows and ordinances govcming this type o/work will be wrnplefed <br /> I whelher specJied heiein cr not. The gianfinc�o/a permd does not resume fo give aufhority to <br /> violate or cancel the provisions clany other sfnte or locallaw reguP6nc�consfruc8on or the <br /> peAormance oI construchon. That/arn aufherized by fhe owrer o/this property to peAorm fhe <br /> �', worB Ior�vhich applicalion is rnade and I cornply with fhe Sfafe Cont�aclors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � � i <br /> ����-�,�l�� � � l-3c�� �� � <br /> T Signawre _ Date <br /> /�f�� - ��� � <br /> I . . _ ,,.� . .. - —---� <br />