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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROJECT ADDRESS <br /> :ic:�'_iNA/j-1:1�.ilN /� JiV��c i!/l G`Al,ES /� 1/c. �A 1- VrX'IvTi `lSA `� ��C I <br /> Owner Mail Address City Slale2ip Phone <br /> Tenanl Mail Address Cily Slate2ip Phonc <br /> l 9�1S�C� : <br /> ���uS?f' (� ICcI-r'ic l��';t�S /('U ��P N �=. Tu��n1-I(' UJ� �s�' L �I <br /> Eleclrical Conlraclor Mail Address City Stale2ip Phone <br /> ��OWi=/�1= :I; �`)/p-S �L�DO '� <br /> Slate License Number Conlract Price of Work <br /> 7C f�� < ��. �cd�5 M2.5� �$�/-s'kG <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description o(Work to Re Done: ��h(�_ �- C f-{AN C r. . <br /> NOTE: VJIRING IN NON-DW ELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhat I have read and exarnined thi;application and kne�v the same to be frue and <br /> correct. All provisions o(/aws and ordinances goveming fhis type ol�rork�rill Ge canplefed <br /> �rhefher speciGed herein or noL The granting of a pernut does not presmne to give authonty to �^ .� n <br /> violate or cancel U�o provisions e/any other sfafQ or local lau�regulaGng consfruction or the ` l..-Zy <br /> performance ol construction. Thaf 1 am airthonzed by the o�vner o/fhis property to pedonn Ihe J <br /> work lor which applicafion is rnade and I comply�vith the Sfate Confractors Law 18.27 RCW and �� �/ <br /> 296.200 WAC. <br /> �-- ,_ � , <br /> , > >� �',�06 <br /> � / Z /, / <br /> � Sigmture _ . Date �/J, <br /> �i J � <br /> ._ �� <br />