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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8$10 - FAX425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � �,' � �'G��u./���,-V � L�l ��U �/✓/Z , <br /> PROJECT ADDRESS <br /> � ��; �-1 l �i-l; �/ �c�lz �'c�<; vl .,;� �yJ�:�i' l <br /> Owner Mail Address Cily StateRip Phone <br /> Tenanl Mail Address Cily Stale2ip Phone <br /> 'i'�L •����/7 <br /> Eleclrical CONraCbr Mail Address City StalelZip Phone <br /> Slato License Number Conlract Price of Work <br /> S 7G�1��}-�i � _ <br /> Proposed Use of Bi'ding Contacl Person (Plan Review) <br /> Description of Work lo f3e Done: � � 1 2�K � � ` u'�--�Z-�.-t S I�� G11��l '�du/C� � ��/ <br /> l G /� � -V �/�.ltOKi/1�P <br />� — <br /> NOTE: WIRING IN NON-DV/ELLINGS IS REQUIRED TO FEE <br /> E3E IN RACEWAYS, MC OR AC CABLE. <br /> I <br /> CIT'f OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> , 1 hereby ce�tily Ihaf 1 hm a read and exammed lhis applicafiqn and knov Ihe same fo be true and , `'�Qg <br /> correct. All provisions olla�vs and ordinances govemm�fhis type oI���ork�vill be completed �C ` �)L�3 <br /> whelher specilied herein ornoL The granting oIa pernut does nof �resurnc fo gi��e aulhonty to v <br /> violafe or cancel fhe�rovisions of any other state orlocallaw regulaling consWc6on orthe <br /> perfornrence o/construction. That I om nofhonzed by fhe o�ti�ner o/this properly to pa�/omi fhe <br /> �voik lor wfzich�pplicafien is mnde and(comply with fhe Slafe Contracrors La�v 18.27 RCW and i <br /> 296.200 �C �i � / � � 9�,.i"—� <br /> •�`7--. <br /> i �� ;� • �� <br /> Signalure � L Da <br />