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ELEGTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—vwuw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ���i ��p,�,�,�i��� P,��� �i,,������ <br /> PROJECT ADDRESS <br /> 'j�.,?5=7'i�.2 • �/6 E <br /> /' /' ���J ,�7./' �s o i G /i/r,�t�r,r s�' ,�J2 5����n� �,�.� �• ' � � y /. <br /> Owner Mail Address City Stal 2ip Phone <br /> Tenanl Mail Address City Stale2ip Phone <br /> �G�a:,:.i..i _It''�:�i . `�C ���e�1J ,1��,/Aedk) �✓.��r��i' /�.4 ��D3L °L�,l��`��.'.�•')/(v� <br /> Electrical Conlraclo Mail Addmss Ciry State/Zip Phone <br /> �I�'���%D�J b � . � �,, <br /> Slale License Number � Contracl Pric of Work <br /> ��C `f.��,� .�nf' /J'/.�/� �YIcXi�.,._.� <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> Descriplion of Work to Be Done: �i�/Q� ��lu /TA � /��i7 @ <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 IS 3105 <br /> 1 hereby certify that I have read and examined fhis applicafion and kno�v fhe same fo be true and <br /> correcf. Al/provisions ollaws and ordinances goveming this fype ol work will 6e completed <br /> whelher specified hrrein or noL The grantin�ol a permd does not resume fo give aufhonty fo <br /> violate or cancel the provisions ol any other state orlocallaw reguPfing constructron or the <br /> periornwnce of construction. That 1 am aufhonzed by the owner o/this property fo perform the <br /> �vork lor which application is made and 1 comply wifh the Stafe Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ^ nl'a� i� ���� � ' -s�-�� �� 5 ' � , � f � <br /> Signature Date � r <br /> l'/ . ; <br />