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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 425-257�8 10 DAFAX 425-257-8857 -www.eve?ettwa.org G ` b�O� <br /> G- � �0,3-� �D <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��;D 2� �»r�i�rr�F'-� �n,%>� �',;r- �c.�- <br /> PROJECT ADDRESS !I <br /> �1l r' � <br /> Ti��r r�/�� L�c�-�� f -�yi�C� l3/s�f�z�t� Sf fi7Ul��n��r�;Gi v�'Y-J 9a'.��f�v yIi-��-� <br /> Owner Mail Address City Slate/Zip Phone <br /> Tenant Mailllddress Cily Slate/Zip Phone <br /> �G L�J2�L��2 <br /> ElectricalContrector Ma��Address Ciry s�aterzip Phone <br /> State License Number Contract Pnce of Work <br /> SF�. ��rl��°<<z r�cU�)�'U-�-93�is <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description oF Work to Be Done: <br /> ��' ir�7 �C�jL G� �vG/� <br /> � <br /> NOTE: WIRING IN NON-DWEIIINGS IS REQUIRED TO Ft� <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceAily fhat 1 have read and exarnined fhis application and kno�v the same ro be hue and <br /> correct. All provisions olla�vs and ordinances govenung this type o(�vork�vill be completed <br /> whelher specilied he�ein or noL The granfing ol a pernut does no( resume fo grve aulhonty to <br /> violate or cancel fhe provisions ol any olher state or local law reguPting consfruc6on or(be <br /> pedonnanr.e o/consVuchon. That I am authonzed by the owner o/this properly to perfo.-rn fhe <br /> �vork lor-wt �ch application is made and I compty�vith fhe State Confracrors Law 1827 RCW and <br /> 296200 W . <br /> / �� /> <br /> �1..'/�7�7 �/ ' ' l.. � t�'�` a����)�� <br /> Si9naWre ` Date / I� / <br /> C� , I��� <br /> � ; <br /> J <br />