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ELECTRICA,L PERMIT APPLiCATION <br />CITY OF EVERETT PERMiT SERVICES <br />3200 CEGAR 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 I Z ��"O <br />% l.�-Ci�'.�. <br />PROJECT ADDRESS <br />r.��� �} / �` � l / <br />��/ll.'t�ll ��'��r ��.'U � � (� �„%{ �%� �,��n� <br />�>� ��� —vr'/, , rr <br />OWner �1ail Fddress City � Slate/Zip Phone <br />Tenant <br />C�'l�'.s��c <br />E!ectric�l Contractor <br />Slale License Numbcr <br />Mail Address <br />Afail Address <br />��� ,-�ll C�L.c'. 1 . G 1"c� ' <br />Proposed Use of Building - <br />City, <br />Cip <br />StatelZip <br />Slatc/Zip <br />Contrar,t Price of WorF: <br />Contact Person (Plan Review� <br />Phone <br />Phone <br />Descriplion of Work to Do Done: i.'� i v"'�.- i� 1.'., �'`% �� �' �"� �" _ <br />L <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BB IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS :1105 <br />1 hereby certi/y thaf I have read and examined fhis epplication and k:�o�v the sarne fo be f�ue and <br />correct. All pmvisions ol/aws an i ordinances govemmg fhis type of work u�ill be complefed <br />whether specified herein or noL The granfing ol a permd does not resume to give aufhonty tc <br />violafe or cancel the provisions of any ofher state or loca! la�v reguPling consfruchon or fhe <br />peAormance o(consfruction. That I am aufhonzed by fhe o�rner o/l,us propeny to perfo�m fhe <br />work lor which applic�fion is made and 1 compty �rith tue Sfate Contr;�cfors Law 18.27 RCW ana <br />296.200 WAC. <br />�s� 7 �� , <br />. <br />i�' , :�z•>������. �-� —/.i_-_ . ,5 <br />FeE <br />r'L��i �' — Uc:�_� <br />✓ <br />