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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3�00 CEDAR STREET, EVERETT. WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org 6 -a b-o6 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � �b ob—i �5 <br /> ,� 5 L � ���6�•� U ✓1 ��'� � �,,.,� �t -�i � L.J y� �)� C-�� I ��� 5 ��S <br /> PROJECT ADDRESS 5S yY� <br /> ��� � � <br /> J�:,��. �, ��� ,-i� �:� � i �: � s�s ���,;�r�;�-�.: �a�t �.�., ��� u� n ����� <br /> Owner Mail P.ddress Cily Slate2ip Phone-- <br /> N /,� <br /> Tenanl Mail Address Ciry State/Zip Phone <br /> i <br /> �Ci I � I�)�1.� r'�� � <br /> Eleclrical Conlraclor Mail Address Cily StatelZip Phone <br /> '�� s�,c� <br /> Slate License Number Conlracl Price of Work <br /> ,��..<<,� M � �4c � II <br /> `>� �:�j �P '� �t��e-� i �Y� ���2 SI C.'( '-t( � — <br /> Proposed Use of Building ' Conlact Person (Plan Review) <br /> Description of Work lo Be Done: ��� ���< � �i �r`�� � � r N_��' �� I C � `'"`' , <br />� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALC-S TAX CODE IS 3105 <br /> 1 he�eby certily tliaf 1 have read and e::amined this application and hno�v the sarne fo be Irue and <br /> correcL All provisions oflau•s and ordinances govenunr�this lype ol work will6e cornpleted <br /> whelher speciGed herein or noL The granting of a pernut does not resurne fo give authonty to <br /> violafe or cancel the p�ovisions olany ofher state orlocal law reguPfint�conSVucfion or the <br /> performance of constnution. That 1 am aulhonzed by fhe o�rner o/flus property fo peAonn(he <br /> work lor�vhich application is made and I compty with fhe Sfafe Confractors Law 78.27 RCW and ! <br /> 7 ` <br /> zs�.zoo wnc. � <br /> �. <br /> ;� - � �/ (-�z Z ��'(� l,'Z' <br /> � <br /> -- SignaWw � Dalo <br />