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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMII' SERVICES �Z�-,�a7 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everetlwa.org L��/Z--03 7 <br /> / <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I (; (C' t-�c, I � �.v-e� <br /> PROJECT ADDRESS <br /> �` � �{'il� ��(O �G�ti ��C. �� 1'E �� \N�� iD'ZU� ��' LS—Z<s"" c"r• <br /> � ��� � � ���� — <br /> Owner Mail Address City State/Zip Phone <br /> I <br /> '- .;��� Mail Address City Slale/Zip Phone <br /> , <br /> 117�'ti/'�- l�lN� z �� <br /> Eleclrical ConUaclor P.1ad AAdress City SWie.2ip Phone <br /> State License Number Contracl Price of Work <br /> Proposed Use o(Buildin� Contact Person (Plan Review) <br /> Description of Work to Be Done: �`'' —' �-eU n � � � � � CL �^' 1�'� [� Jt.�-�� <br /> �'��'C � � -� S <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fh�f I have read and examined fhis application and kno�v fhe sarne to 6e Gue and <br /> correcL All provisions ol laws and ordmances goveminq fhis type o/work u II be complefed <br /> whefher specdied herein or noL The c�ranfing ol a permd does not resume fo give authonty to <br /> violafe or cancel fhe provisions of any other sfafe or local law reguPting corstruchon or the <br /> peAomiance o(cpo/�struction. Tha 1 am aufhorized by Ihe owner o/fhis property to perlorm fhe <br /> �vork!or which a J�I)�fion is mad and I comply�rilh Ihe Sfate Confracfors La�v 18.27 RCW and <br /> 296200 WqC.! �.' , <br /> �'� � r 7 - �7 - v � <br /> Sipnat e Date <br /> cc��� Z-v37 <br />