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ELECTRICAL PERMIT APPLIC'A.TI�DN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � -16 -/D <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> Cioo}�-09 � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> a��� �-�oR� <br /> PROJECT ADDRESS <br /> OWner �dail Address ��� <br /> 1' Stzte2ip Phone <br /> Tenant Mail Address City Stalo/Zlp Phono <br /> S - �c�-�,,;c. CL� �k��� (J�A. q����('�Is��'fn <br /> Eleclncal Conliaclor � Matl Address � <br /> ���Y Slale/Zip Phone <br /> 5����N Se � 3 �� ��� <br /> Coniract Prico o(Work <br /> Propose�e o�y �� I y �S� r��e' <br /> Contact Person (Plan Review) <br /> Description of Work lo Be Done: SQY���t�_ �/��' L(�a��1 r, ./1� Q <br /> rz o7 � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES 7AX COaE IS 3105 <br /> I hereby certily Ihat I Irave read and exarnined fhis app/icafion and know fhe same fo bo Wv and C��U V� U / p <br /> cennct. Afl provisions o/laws and erdinances govemmg(h�s type ol work K-ill be complefeJ <br /> wheU�er speaGeAherein or noL The granting oI a pennd does nol prosumo!o give authonty to <br /> violate or cancel the provisions ol any ofher stafe er/ocal law regulafing cons(nicfion or 1ho <br /> perfomianr.e oI construction. 7"�at f am aufhorized by fhe ownei o!lhis prope�f��to perfomt the <br /> work! rhich applicati 's n do •d 1 comply wit0 fhe State Contracfors Law 18.27 RCW and <br /> 29G.100 AC. � � <br /> / � <br /> -�=✓ - - � �� � - �d <br /> _� Bnature - � �J <br /> I <br />