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-- { <br /> ELE�TR�CAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I p�--� �b <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org �/D�z��� <br /> APPLICATIONS ARE ACCEPTED FRO�I 8 AM TO 4 PM <br /> � �-��� r� ��-\ . _ <br /> PROJECT ADDRESS <br /> �- Y��('" I r�n�`� � I n� �-�i �r� ���. t �f��'e��- L�J{� �G'i fi-�,L— <br /> Owner Mail Address Cily StatelZip Phone <br /> �����;IIP 3 I U`_�' -�1 i ro_S� . -�J�rro� l`1fl k'i �s2c�l <br /> Tenanl hlail Address Ciry Slate/Zip Phone <br /> � � �71C`fl���� WI�% ���V�l(,����in� nIY� �1�—�� 3l6'�'�/l'/��/ <br /> Eleclrical Co actor Mail Address Cily �i Sta�e2ip Phone <br /> S`{��,-�t 1 x t-�(ol��Pi� � `��"�lY�. l'Y� <br /> State License hwnber Conhacl Price o(Work <br /> i�Q `_�s�-��m. ,�:- ��.! C('O <br /> Proposed Use of Building Contac Person (PI Review) <br /> Descriplion of Work lo Be Dane: � Y1�1'� /'i t I ( � � ���'(�(t �n7 � i"l <br /> NOTE: WIRING IN NON-DINELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br /> I hereby cerlily fhat I have read and examined fhis applicafion and knav Ihe same to be true and <br /> correcL All provisions o/laws and ordinances governinr�fh�s type ol�aork�vill be compleled <br /> �vhefher spealied hercin or noL The c�ranfmg o/a perrnd does not presume to give authonty lo <br /> violate or cnncel Ihe provisions o/any other sfate orlocal law regu/ating consfrucfion or the <br /> pedormance of construcfion. That I am authorized Gy fhe owner o/Cas property fo perfonn the <br /> work/or vhich applicafion is made and I cornply�vifh the Stale Contraclors Law 18.27 RCW and <br /> 96.20 AC. <br /> � � 3� <br /> �— ��'- �� r� ,o l� - � <br /> - Signature Date � <br />