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ELECTRICAL P��RRMIT 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 /> i-����;�i Ca P� ��d��i� <br /> PROJECT ADDRESS <br /> �'� A%�UL'�ODAf1f�� ,� l��l$�b ///e.Qp,�� N�� ] 7G e�Od l9n�D A 7��� <br /> Owner Mail Address City Slate2p � Phone <br /> Tenant Mail Address Ciry Slate2ip Phone <br /> �/� �{.Ri='I�af • �/Glo <br /> � �iEi �� �'ir:%�� �.uC' I7�OSl ,�Ja•+�QoL 4J /d�.h✓i��s ��,4 7�oa� <br /> Electrical ContraC r hlail Address Ciry Stale/dp Phono <br /> �'I�� �'N� %/a °2 � � \ <br /> State License Number Conlracl Price o(Work <br /> /7/)7� /1��0 � A � � wJr=. <br /> Proposed l�se of Building ' Contact Person (Plan Review) <br /> Descripfion of Work to Bo Done: ' �N �� � � <br /> � <br /> / <br /> / <br /> % <br /> % <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. -, <br /> �.� ��.�� I.� <br /> CITY OF EVFRETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that 1 havo read and examined fhis applicafion and know the same to be true and <br /> correcf. All prov�sions ollaws and ordinances goveming this fype ol work will be campleted <br /> whefher speci(ed herein or noL The gr�nfing o/a pemuf does nof presume to give aufhonty to <br /> viofafe or cancel the provisions o/any tlther stafe or local law regu/aGng consfruct�on or the <br /> pe�formance oI construction. lhaf 1 am aufhonzed by the owner ol this property to pedorm the n/ <br /> work for which application is rnade and I comply with the State Confractors Law 18.27 RCW and ih j /�' �� <br /> 296.200 WAC. � <br /> , � <br /> � �, i <br /> // � , /J-' •_ 9 " /� U �o <br /> SignaWre Date <br /> (p� � - �(��- <br />