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; <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � _1z_o6 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8610 - FAX425-257-8857-www.everettwa.org U''o6o9-as2 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � � �(I1111/le� �l�c'I• ��I,pf�,Q� � ��D3 <br /> PROJECT ADDRESS <br /> � �i.l � l a� ��9�� <br /> (.Z� ' i'1(1x(�1 � )K� ���'f�dAS� �i"�� � 8 �Z �p� af�" <br /> Vwnef Mail Address Cily SWte21p Phone <br /> Tenanl Mall Address City State2lp Phone <br /> ��r, , � � <br /> r <br /> EleCtdCal Contraclor Maii Address City Slale/Zip Phone <br /> Slate License Number Conlracl Price of Work <br /> s . .L�l� �r,�,..,,�/v <br /> Proposed Use Building Contact Person (Plan Review) <br /> Descriplion ot Work lo Be Done: LU�I' i-C) L� /,/.IJ`'.h 0 T/XJ L r�«7'LC/.�.(' �.KG7�4�a � ��t0a�+cs+�-�r <br /> V <br /> z" � <br /> r L.-, � , S. ' ) Q �—L�� -r�` / <br /> NOTE: WIRING IN NON-DWELLINGS iS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERE•TT LUCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily thaf I lia��e read and exomined this applicafion and know fhe same fo be true and <br /> correct. All provisions u/laws and ordinances goveming this rype ol work will be completed <br /> whether specified herein or not. The granfing ol a permd does not presume fo give authority to <br /> viofale or cancel ff�e provisions ol any ofher state or locallaw regulsting construction or the <br /> peAonnance of construction. Thaf 1 am aufhorized by the owner o(this property to peAorm the <br /> work lor which applicafion is made and 1 comply with the Sfate Contract rs Law 18.27 RCW and <br /> 296.200 WAC. r]. <br /> �� ',� ,r•� � z �,� ���. � � <br /> SignaWre Date <br />