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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 /> ��QL-� � � _otJ p,(��,i /�/a���/U <br /> PROJECT ADDRESS <br /> ����UI' OANi_�,J t Jf.,� 19�1�5�b �Q�//bJ81'�✓Q ) T�'-�a'lU� /9i�/��e+a(_ A 7a��.,'�� <br /> Owner Mail Address Clty State/Zip � <br /> Tenant Mail Address City Slate/Zip �� ��� ���� <br /> /1/�.Vi.�.�t . /�J�wr�O.r �i±/' /�30,� ,�'a"��HUl G.J ��il�✓Iv�S ���4 �7�.�� <br /> Eleclrical ConlraC r Mail Address City State/Zip Phone <br /> ���C �/�. NF �/D � _7 �, <br /> Stale License Number Contract Price o(Work <br /> /Y�7'� /Y�/J� A °� �aw�r'. <br /> Proposed se oi Building Contact Person (Plan Review) <br /> Descriplion of Work to Be Done: (C� �N i7 '� � <br /> NOTE: WIRING ,. NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �..+C; �' n� �� <br /> 7 �. <br /> 1 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceAily that 1 have read and examined this applicafion and know the same to bo frue and <br /> correcf. All provisions ollaws and ordinances goveming this type olwork will be compieted <br /> whefher specified herein or not.. The gr�nfing o/a permif does nof presume fo give aufhority fo <br /> violate or cancel fhe provisions ol any tlther state or local law regulating consfruction or the <br /> per/ormance o(conslruction. That 1 em authonzed by(he owner o/fhis property to perform fhe <br /> �vork Ior which application is made and I comply wilh Ihe State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> j U <br /> ,�.�.1,C�� .�1 ``����uti� �"=i� v � � � /�� . - <br /> Signalure Date <br /> � <br /> Lvo � � l�/ <br />