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ELECTRICAL P�RMIT APPLICATION <br /> :� <br /> CITY OF EVEF�ETT�PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi', W A 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� ��o���o;i� �01 P,�w,, /�ia�� l� <br /> PROJ�CT ADDRESS I <br /> �` ,('l _U _�DOAf1�,Jf �� 19�1'S�b eQ2An.iQf�D ��0� l9oL��ND(_ A 7o��.,Z� <br /> Owner Mail Address Clly State2ip � <br /> Tenant Mail Address f,i;y Stale2ip Phone <br /> �{�='���• �/G� <br /> �j.�z,;r . �yN.�e:,. D.�� /�3os' ��a���l�� � ���,��s �,� �yoaG <br /> Eleclrical Conlrac r Alail Address City Stale2ip Phone <br /> /1'/��C = �F �/D °,� .7 � <br /> Stale License Number Contracl Price of Work <br /> /`Yn7� /1��0 �AQ/1 N.t�ia��=�/ <br /> Proposed se of Building ' Conlacl Person (Plan Review) <br /> Descriplion of Work to Bo Done: Lt//2� ��L-) �C'^ �N /7 /4a '� /l l!� P <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. , <br /> �y � y.� �.� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i I hereby ceAi(y fhaf 1 have read and examined this applicafion and know the same to be frue and <br /> correct. All provisions ollaws and ordinances goveming tlus fype ef work will be completed <br /> whefher speafied herein or not.. The gr�nting ot a permd does nof presume to give authonly fo <br /> violale or cancel the provisions olany tlther s;ato or local law reguleting consfruction or the � <br /> perfomiance o/construction. That 1 am aulhonzed by fhe ownerol this�roperty to pedorm the <br /> work lor whrch application is made and I comply with the Sfate Contractors Law 18.27 RCW and �D ) (��� <br /> 296.200 WAC. <br /> �l� �l/ .�9 �` Gs/ ��/6 --1� 6 <br /> ��� <br /> ignalure Date <br /> G�os_,(�3 <br />