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ELECTRIGAL PERMIT APPLICATfON <br /> CITY JF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLII:ATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 5 _�� . D,b <br /> v��b ���� r� �e � ��� <br /> PROJECT ADDRESS — � (�j O S v'�� <br /> '� � 1 � <br /> 9vCJ�� \ lf �(/ ��� �/� <br /> Ownef Mail Address City St�te/Zip Phone <br /> -- <br /> Tenanl Mail Address Ciry Stale/Zip Phone <br /> � <br /> C �,� " S C�P�, —�L �57�s� � /J4, s��n c✓o�.� k/� <br /> EleCtfical Con�ractor Mail Address Ciry Stale/Zip Ph ne <br /> l �N-� �60-3.���(�,�3s` <br /> l�- L--GiY� ���'-� l � � ��� Lr�iJ. co <br /> Slale License Number Conlr cl Price of Work <br /> T� � Ie �� � �rs � <br /> Proposed U�e of Bui ding Conlacl Person (Plan Review) <br /> Description of W rk lo Be Done: ��V 1PI� �t"1� O 1 C.�', , <br /> �� C�C �� rr — I�r S, <br /> NOTE: WIRING IN NON-C\NELIINGS IS RF�UIRED TO FEE <br /> BE IN RACEWAYS, MC GR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 'nereby certily fhaf I have iead and examined fhis application and know the same to be true and <br /> conecL Allp!ovisions ollaws and ordinances�o��emin�Ihis type o/tvork tvdl be cornpleted <br /> whefher ed herein or noL The granfing ol a perrnrt does not presume lo give aidhonty tu <br /> violate r canc I the provisions o(any other slafe or local law regulahng construction or the <br /> pedo �ance o/ onsfructron. Thaf I am Ihorized by fhe o�vner o/tlus property fo perfonn the <br /> woric or whic:, pplicafion is rnade and ply n�ifh the Sfate Contractors Law 18.27 RCW and <br /> 296. 00 WAC. <br /> � s=�/- �� <br /> Signalure Uate <br /> �cCcS cd`3 <br />