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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 L( � a 6-o.b <br />�"": � �� �/�Lf�i���Ul'� /�C�� � -Lt r �C-- � <br />PROJECT ACDRESS <br />-1 r <br />.��Q�)�. �u.nt� <br />Owner <br />�.JCi <br />Tenanl <br />M11ail Addmss <br />� IJ i'�(:<<i <br />Mail Address <br />�LiiClLa/.;� <br />Clectrical Confractor Mail Address <br />�� Vl� � � 1_ � 1 �-f � � �.�.� � <br />State License Number <br />��t � (J,�-�,� ��w�'�'�,.vrn/v JGY��=f,cT <br />Proposed Use a( uildinc� / <br />Descriplion o( Work lo Be Done: ,yCl l�� [/'� �3 <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLF. <br />CITY OF EVERETT I.00AL SALES TAX CODE �S 3105 <br />1 heieby certily thaf I h,vve read and examined fhis applic� <br />correct. All provisions alla�vs and adinances �overmng <br />�vhe(her spealied he�ein or not. The g�anting o/ a pernut <br />viofafe or cancel fhe Inovisions ol any other state or locai <br />pedormance olconstrucliai. That 1 am authonzed by fhc <br />work Ior which application is made and 1 comply wi(h the <br />29G200 WAC. <br />_ ..__ . <br />�--- <br />. _—_— --- <br />_ __ <br />; � . _ .. <br />Stale2ip <br />State2ip <br />Phone <br />Phone <br />iYLz3 <br />�Zo4,�qZ�_ 3aSj <br />r/ <br />��UUd �- <br />Conlracl Price of Work <br />Conlacl Person (Plan Review) <br />and know fhe sarne to be true and <br />}�pe ol work �vill be cornpleted <br />c nol resume W give airthority to <br />�eguPting consvuction or the <br />er o/this property to perfomi fhe <br />� Contractors Law 78.27 RCW and <br />��� <br />��J <br />FEE <br />, -� <br />. <br />,/, �� <br />1� C�%�� � <br />