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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERPJIIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-3Y.57 — www.eve� ettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��720 1,��. h�c<<;� v;c�� `�r. _ <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />City <br />Stale/Zip <br />��..as-�'? <br />�0511—i7� <br />Phone <br />EnC'�Y�r�iY�< <,���-iCYf��- 2�Zc: L��►Tt�_;;r��r�J �k?rr�i- ��� <br />fenanl Mail AdAress C.''+ Stale2ip Phone <br />Electrical <br />hlail Address <br />�� �-P I�C�G� PK <br />Slale L�.,.nse Number <br />1lci/ Ci� 1� <br />Proposed Usc ol �uilding <br />Description of Work lo �e Done: <br />NOTE: WIRING IN NON-DW[LLINGS IS REQI'!RED TO <br />BE IN RACEWAYS, MC OR AC CADLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />G'Y <br />`� 3,`_�Gr'� • � <br />cont act Price or work <br />�" <br />Contacl Person (Pla� R� <br />1 h�aieby ce�iil}� Ihaf I have �ead and exaniinod this applicafion and know th� same to be true and <br />corrzcf. All pio��isions ollaws and ordinances 9oveming fhis fype o! �ra�k nill be cumpleted <br />u-helher specdied herein or noL The g�anfing o�a perntd does not reswne to give aufho�ify to <br />viol�vte ur cance/ fhe urovisions o/ any other stafe or local lan� reguPting construcfion or fhe <br />pe�lormance olcnns6uction. That I am aufliorized by Ihe o�vner o/ flus prope�ty to pe�fomi 8�e <br />work I hich applir.a(ion is made and 1 cornply �vifh the Sfate Contrac(ors Law 18.27 RCIv and <br />9G.2 0 WAC. <br />/ � <br />J I� �/� <br />- I � �1 � � � � —1—'--11 � <br />Inn.aWre D, e <br />FE� <br />�l'X?i�- I�� <br />Phone <br />