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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ( -- (7-I Z <br /> 425-257-8810 - FAX425-257-8857 -www.everettwa.org � I�'VD�n <br /> / <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ���I( �n�,� A�'�� — <br /> PROJECT ADDRESS <br /> {� r��1 I �n,+w.1cQA�. ��sr�k} 1,�. �1Q�Z0 � W�S"'303"073 <br /> Owner ' M11ail Address City State/Zip Phone <br /> Tenan� Mail Address City StatelZip Phone <br /> �` ��Q'�LI[�.�Q-�.1G—�n '�tC�{¢� --Q2rP'� l�- �lQ�?r�n_ �'�"�`�^`�3 � <br /> [IectiicalConlractor MailAddress City Stale'7�: Phone <br /> �,C��SG {�- <br /> Stale License Number Contract Price of �o k <br /> �P��C�I��Grr� <br /> Proposed Use of auilding Contacl Person (Plan Review) <br /> !� `_ i <br /> Description o(Work to Be Done: �"���J1C 'L Y`c11$� l�l�-�'r"�� 11� C{li�a" SD{�� [��[/ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIR[D TO FEE <br /> BE IN RACEWAYS, fv1C OR AC CABLE. �O(�� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 he�eGy cerlily Ihat I have read and exarnined fhis application and know fhe same fo be frue and <br /> correc(. All provisions ol laws and ordinances governmg Ihis lype a(work will be complefed <br /> whether specilied herein or noL The gran(ing of a pernuf does nol preswne to give aufhonty to � -� n [�� <br /> viola(e or cancel fhe f�rovisions ol any other sfafe or local law regulating consfnic(�on or fhe l t�J �� Q J <br /> peAcrmance o�constnicfion. That 1 am airthorized by the owner o/fh�s properiy fo peAorm the <br /> work loi whicii application is made and 1 cornp/y wifh fhe State Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �� �� ��-- � � � ��� '�— <br /> Siynalurc Date <br /> . . ._ . _ . _. . _ ____-__"__._ — --J <br />