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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMYT SERVICES <br /> 3200 CEDAR STREET, EVER�TT, WA 58201 <br /> 425-257-8810 - FAX 425-257-8857 -wwva.everettwa.org -� �a� �b� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEP7EU <br /> '.� ' F� /"!/'� nti'E' viE'.v O.e � ✓E <br /> PROJECT ADDRESS <br /> GrIR-�' `�a��F'�- ii�•^.. �� n�n.•_�N� viF.., a�2 G�iFr...- ii � WA `��u'.'1f `/d5-dSd•y6 � <br /> Ownef F.'m�Atldress City State/Zip Phone <br /> OC.v �.�F..'v JCG..�-F� I ('}f1 <br /> Tenant Mal Address Ciry State!Zip Phone <br /> OwNEti. �.� � QG s� i. � Wvh� <br /> El=ctrical Contractor Mail Address Ciry State2ip Phone <br /> � <br /> �U �T� E� .— 75G 7 <br /> Stcte License Number Contract Pnce of Work <br /> �A J <br /> � �N4'.F[n,+� � �Y I('E.=,1 CJC nC�F � ('c. � '1'6J7EN <br /> Proposec' Use o(Building Contact Person (Plan Review) <br /> DescriptioncfWorktoBeDane: /�'EF onE Ex�s7'��vs i3�.r��x�2 i�nwifr_ - f-En .�c' in� <br /> `sl�7C LJ/-fJi /GN - 2N^T�LL ? /�n..�._.nn .n. g P/_� (-�S� 1�.�E.P�.ACF_ E {.�(Cr. <br /> /dSATe;•"-S� K'l-.Pc��E �EC,P'S 9- - i " �ra., r7G.JFS - .CEc.:�n.-�= E�t�'Gi STc.tll. <br /> i <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TtJ(COGE IS 3105 <br /> 1 heieby certify Ihat I have�ead and examineu�;�is application and kno�v fhe same to be true and <br /> correct. Ail provisions o(laws and ordmr,�^es g�rveming fhis type o!work will be comp/eted <br /> whether specilied herein or not. The c�rantin;�� a pennd does not presume to give authonty fo <br /> violate or cancel the provisions ol any ether stale or local!aw ragu/ating cons Wction or the <br /> perfo�mance o/construc6on. That/am authorized by the o�vner o/this property to peAorm the <br /> work Icr:vhich applicafion is made and 1 comply with Ihe State Contractors Law 18.2i RCW and <br /> 296.200 WAC. <br /> /', /.Z. � i <br /> i ure �e <br /> �J %` �� <br />