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, <br /> � <br /> ELECTRICAIL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR 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 <br /> �Z�v I Itw,tl- ✓��e S�� �e 3oG ��v�'�/� �- �P� Zo I <br /> PROJECT ADDRESS <br /> Ownef Mail Addross City State/Zip Phone <br /> /Ul�/ �efGS�'�CC Z.210 1t4'iv�"{- �vc ��e���� �n/�, ��cC'Zol qzy-3y6 � 91 <br /> Tenant Mail Address City Slale2ip Phone <br /> ��� � I k' � �/ �tG ^�I27 <br /> �,c�n`r�l 1��,�.�� �tc� i4c ��L�c� /�%7 (�/f in�, n �✓�_ 1 Z33 �zc � <br /> Electrical Contracto� � Mall Address Cily Slate2ip Phone <br /> �(�U21 L �% ZZ/�IS 3lc�c � <br /> Stale I_icense Number Conlracl Price ot Work <br /> �c+� �, 7l,an��n� <br /> Proposed Use of Building Conlacl Pe n (Plan Review) <br /> Description of Work to Ba Dono: // �1 I 11 I✓1�il �L' ��U �I � C' � /`-�� ' 'lCC' �\ <br /> J <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify fhat I have read nnd exemined Ihis applicalion and know the sarne to 6e We and � 1 L } �- ��( � <br /> correcf. All provislons of laws and ordinances goveming this type of work will be completed <br /> �rhefher specified herein or noL The granting of a permd does not presume fo give aufhonty fo <br /> violafe or cance/the Provlsions o(any ot0er state or local law regulefing consfruction or the <br /> peRomiance o(consfnicfion. That 1 am aufhonzed 6y fhe owner of this property to pedomi the <br /> u�ork lor which application fs m o and I comply�vifh Iho State Conlracrors Law 1P 27 RCW and <br /> 296.200 WAC. <br /> �/ <br /> , '� � 3 c� -/ C� <br /> SI n Date <br /> �� <br />