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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 � `06 <br /> 425-257-8810 - FAX 425-257-8857—www.evereriwa.org s — � <br /> �bbas i�fl <br /> APPLICATIONS ARE ACCEPTED FROM 0 AM TO 4 PM <br /> I � I S ��1��f FIC., /� �: <br /> PROJECT ADDRESS <br /> �3L4CC�(GY ���1 i '� I S �l�t (�IC.I�UL L-6���'C7`T L•�`1� �7��c'�_L__ <br /> Owner Mai�Addreae Ciry S1ate2ip P�one <br /> j�� C(i-I�d�uf'� f�-D(i (51 S �'I�C I FiC�/i��� (���.�=.T1 i.�11���ZG l �2525771�'�,� <br /> Tenant MailAddress City SWtelZip Phone <br /> l(:('VJPG�C �L(t^�ICr IIvC '7Z I AVG p �i4iTr- � �)�-1��v��N ic1i� �1�7�io ���Z � <br /> [IedricalCon�rador MailAtlaress City State/Zip Phone <br /> (c �r�i:1l: �l�i3R"� 9��1� �C� <br /> State License Number Contract Price of Work <br /> ����1 ��:��+�L. � — <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Desalplion oi Work to 9e Done: I I V.� I I� �—�- V��= ��V �/��—� Il[� Il'���7�,� ������� <br /> �i�C�����r , LiN�'� rr1,� TF►-E F�� �u9-����� P�n;�� . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE�S 3106 <br /> I hereby ceRily fbat 1 have road and exammed this applicafion and know fhe same fo be frue and <br /> conecL A!I provisions ollaws and ordinances governrng this�ype ol work will hs compleled <br /> whe�her speci(red horein or no!. Tlre g�antinq ol a permrt does nof presun.e lo give authonty fo <br /> vioL•fe or cancel fhe provisions ot uny o(her sfafe or local!aw requlafing construcfion or'he <br /> pe:.omrance ol consfruction. Tba:�I am authonzed by fhe owner o�fhrs property to peAorm fhe <br /> work/or which applica6on is made and 1 comply with the State Confracfors Law 1827 RCW and <br /> 296.200 WAC. - <br /> � ,; <br /> / i <br /> 1 �,i,� �lL ,��' ( � � �" �_� �`� —iC1 —��� <br /> L <br /> Signature / Date <br /> I <br />