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ELECTRICAL 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 /> i LZ� V�R��� �� <br /> P�20JECT ADDRESS <br /> �/ZS�) <br /> L�r1I�� j 7 ?I L�q�'� /����-. ���� � {� W�" ��'� 1 .3�7y - 79�'7 <br /> Owne� Atail Address City Stale2ip Phone <br /> Tenanl A9ail Address Cily SlatelZip Phone <br /> yza7 <br /> i� � Eu.:cr�c-�Tl..� 2�1ZS ►�b'''' P� s� �e.�1f ti�w4- cjb'19b' - o c,�X9 <br /> Electrical Conlreclor A9ail Address Cily Stale/Zip Phone <br /> i <br /> � 3 ��� '�i, `J5 b��/ b ���� <br /> State Licenso Number Contrecl Price of Work <br /> Proposed Use of Bui�ding Conlacl Person (Plan Review) <br /> Descriptlon o(Work lo Be Done: �'D�GLC OLJ Z�D� �L�'l��C�- I�.��L 1 l,. �l�l /`-.=�J �OOa� !^(�`x i��GJ`L <br /> —��'. � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, R4C OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi!}�Ihat 1 have read and exarnined fhis application and knorr tiie same fo be We and <br /> correcL All prov�sions ol la�vs and ordinances�ovemmg fh�s fype of work will be completed <br /> n4ieU�er speal�ed herein or noL The granting o/a pernut does nof resume fo give aulhonty to <br /> violafe or cancel lhe provisrons oI any other sfate or local law reguPfing const�uctwn or the <br /> pedomiance of construction. That I am aulhonzed by fhe on•ner o(Ihis property fo perfonn ihe <br /> u�ork Ior which application is made and 1 compl}��+'ifh fhe Sfate Contractws Law 18.27 RCW and <br /> 296.200 WAC. ( <br /> � <br /> _ �� t%`', .7 �l ���r��� � 5�� �z���7 <br /> ... - �Signa—Wre '� � Date <br /> . � ��/ (. �_� I <br />