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ELECTRICAL PERMIT APPLICATION <br /> CITY OF E�✓ERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> '� n � C� <br /> !C'; l > . /%':��:�� �.,,' �-,t� ,., t7,2.i�'�� <br /> PROJECT ADDRESS <br /> i /' <br /> Uwner Mail Address City StalMZip Phone <br /> (� �(P/T(- �. - /`.�1L iJ .-.�.t:; i �r l'�1:. �'/2 lV� /,�1: �Sri' �'�I.S� dS`� -�" ) <br /> Tenanl Mail Address City State2�p Phone <br /> EleCiriCal Contraclof P:tail Address Cily Sfate;Zip Phone <br /> 3' . <br /> `Y � c:;U <br /> State Licanso Number Conlract Price of Work <br /> it+.�r.ti': o( �P �'qp.•,� :7'ion.� /'.•�� ���Jr.��� <br /> Froposed U•e of Buildinc� Conlact Person (Plan Review) <br /> Dsscription of Work lo Be Done: l - ._� ;�r.., :t�� ��„� lo ,4rvco� . /'�.,�5 ur. , -�- �- /htir,� �« <br /> �:�_ �t y,-r <br /> NOTE: WIRING IN NON-D41�ELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOC,\L SALES TlllC CODE IS 3105 <br /> I hereby certily fhaf 1 have iead and examined Oiis application and know fhe same to 6e frue and <br /> cormct All provisions olla�vs and ordinances govermng fhis type ol�ro�k will 6e comple(ed <br /> �rhefher spealied herein or noL The�rar.fing o�a pernut does not resume(o give authonty to <br /> violale or cancel fhe Provisions ol any olher state or local law reguPling construcfion or the <br /> per/ormance e/consfruction. That I am aufhonzed by fhe o�vner of this propeRy to perform�he <br /> worF Ior�vhich applicafion is rnade and 1 c�mply wi(h fhe Sfate Confractors La�v 18.27 RCLN and -� / . - �� ;� <br /> zss.zoo wac. -, �_ 1- (,( (- � � <br /> / <br /> �, f . <br /> � � '' ���'�� t�� <br /> Si9naluro � Date <br />