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ELECTRICAL PERMIT APPLIGATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 /� � �p —Q7 <br /> 425-257-8810 - FAX 425-257-8857 –www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> Co�/� /6z <br /> 2gzc:� I—� ��� �-�. ,�1 V � <br /> PROJECT ADDRESS <br /> Z oEi <br /> /1��nl� Z��t� � G.�Jt �l �U� L�/e. ra�l,lf6 W fti C�LU � �7 S <br /> 9�7D <br /> Owne� Mail Address City Slatc/Zip Phone <br /> Tenant A1ail Address City State/Zip Pho <br /> / ', r auq6 <br /> �S�CJI I�7 �I��G' (�Z(��. ZLC . Cl� ��' .>O�L �Cc �IC(f�a�P�^ Lt/ Cf �.�Ub`�.3 �',%/y <br /> .��6 <br /> Eleclrical Contraclo� Mail Address City Slate/Zip Phone <br /> cy c, <br /> SC�%TjF/r%32c� B 7� �'�" �- . <br /> State License Number Contracl Price of Work <br /> �bh�s»�•C[�z.l <br /> Proposed Use of Buiiding Contact Person (Plan Review) <br /> Description of W ork lo Be Done: � 'J /�� F�"`� �"�l/lc7 l� j Z5 �/— 20f�/�>r�P j'b1 <br /> Zt�BI/�'o ✓ �S��a-�� ,�c�> > <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 certily fhat 1 have read and exarnined fhis application and know fh�same(o be fnie and �U� ��- l�r,Z <br /> correcL All provisions of laws and ordinances govermng fhis type o!work n�ill be complefed <br /> whether specibed herein or noL The granfing o/a pennit does not presume to give authonty to <br /> violafe or cance/lhe provisions ol any ofher stafe or local law regu/ating construchon or the <br /> peAormance oI consfruction. That 1 am aufhonzed by the owner of this property to perlorm the <br /> work lor wliich applicafion is made and 1 compty�vith the State Conlracfors Law 78.27 RCW and <br /> 29G.200 WAC. <br /> ��_.�Il',���„��j � / '��/C� 7 <br /> Signature �; Datc <br /> v <br />