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ELECTRIC.4L PERMIT APPLICATICIN <br /> CITY OF E\/ERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 4'L5-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> . ' <br /> �. � � �, llr� c �l �'� ll,C' ✓" <br /> PROJECT ADDRESS L� <br /> �. / � � <br /> � �' /� '� l� ��� S�i S�'�i.v�.2 �v� ����� r'J � - <br /> OwneF Mail Address Ciry State/Zip Phone <br /> ! <br /> Tenant Mail Address City StatelZip Phonc <br /> ' r <br /> � <br /> �� �' '- .l �� �l �, ,i�. _ <br /> � <br /> E�ectrical Conlractor ntail nddress City Siate2�p Phore <br /> Slate License Number Conlracl Price of Work <br /> Proposed Use of Building Conlacl Person (Plan Reviev.� <br /> , • <br /> � / <br /> Doocription o(Work to Be Done: � �� �� /�^-��� 5 � � �� �� '� �� �� ��� ���- <br /> J <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> CITY OF FVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily thaf I hnve read and axamined fhis applica!ion and know the same to be We and <br /> correct. All provisions of lo�vs and o�dinances novemmp this type ol work�vill be compleled <br /> whelher s,.ecilied herein or not. The granfing oI a permit does not resume ro give aufhonty to <br /> violafe or cancel fhe Provisions o/any ofher state o�local law reguPting constiuction or the <br /> perfonnance ol consin�cfion. That I arn authorized by(he o�vne�o(fhis propert}�to pedonn ihe <br /> work lor�vhich applicafion is made and I comply with fhe Stafe Conlracrors Lan� 78.27 RCIN and <br /> 296200 WAC. <br /> �y ����-'l �t �C � "� �^ C ��� L� V� _ <br /> $19f1B�UfC Date <br /> C ���'L.� � C�1�� <br />