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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32U0 CEDAR STREEI', EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 –www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �3 z r coL �� � e sf'a�e S zo <br /> PROJECT ADDRFSS <br /> ��''���a�e7��° -a�_L �??`c,� CC�r) �'e�., <br /> OWne� At?il Address Cily StafelLip Phone <br /> �S�d�t/�h ,naton MfG��— r v�rP '� wQ <br /> Tenant A1ail Addmsc City State/ZiB�th�//,��q 9 y0(J <br /> �{c�.F��C �-Or'�1WIu.y� �`GQTiO�IS �e 6060 .F, ��e�-S�C'_d�^ �,zS�y83•595 <br /> [CClri� 41 COnlraClOr A1sil�ddress City State!Zip Phone <br /> pa< �'�G C `I �� .� Z �f � T. .�Zj I <br /> 3tate License Number �Contract Price of Work <br /> Q�'�c�? .�_L_�_h�%n Pn <br /> Proposed Use o(Duilding Conlad Person (Plan Review) <br /> DesuriptionofWorkloBeDone: �OW V�« �—a{/Lfl��1 ��� Ge � a�� _ <br /> i <br /> NOTE: WIRING IN NON-C`WtLLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAI.SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf I have read and examined this applica(ion and kno�v fhe sarne fo be tnie and <br /> correct. All prowsions ella�vs mid ordinances govemmg tlus type ol work will be ccmplefed <br /> whether spec�licd herem or�oL The granling ol a pernut dues not presunte ta give aufhority fo <br /> violate o�cance!the(�rovisions olany ofher stafe or local!aw regulating construcfion or the <br /> r�erfonnance of cunstrucfion. That 1 a,n au(horized by fhe uwner n/fhis p�operty to pe�form the <br /> ivork Ior which application is made and 1 comply�vith the State Contractors Law iQ.27 RCW and <br /> 296.200 WAC. <br /> SignaWre Date <br /> Fu�,u�-v�lZ <br />