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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT P�RMIT SERVICES <br /> 3200 CEDAR STREET, FVERETT, W�138201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> c <br /> PROJECT ADDRESS <br /> C_- 7 (TC�( i'�\ d�ci / ,__�c� c � IJJ.— i..� /YL�I� S�� F�/`-c..c....'�(i �'� �� SJ^ �L <br /> �r� 5 <br /> Owner Mail Address City Slate2ip Phone <br /> Tenanl �1ail Address Cily Stale/Zip Phone <br /> ��/ � � � //�- �15� }' 3�SS .rJ�T <br /> ��SJ �<_�� 7_� /-, �r 7 <br /> Eleclrical Conlr2clor Mail Address Ciiy Stale/Zip Phone <br /> Js�� i h,� ��1� �l � _ �.�f_�-. <br /> Slale License Number C : ��tracl Price ot WorY, <br /> „', . . `� '�' — <br /> Proposed Use of Buildinc� Contact Person (Plan Review) <br /> Description o(W ork to E3e Done: c=l << ��� ��+' .`c � � �-� <br /> NOTL=: WIRING IN NON-DW[LLINGS IS REC'�;^ED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhat I have read and examined fhis application nnd knew Ihe same fo be irue and <br /> conecl. All provisrons ollaws and a�dinances goveming this type ol work n�ill be completed <br /> whetherspealied herein ornoL The yranfiny o(a perrruf does not r.esume to giee authnrity fo <br /> violafe or cancel fhe provisrvns o(any other stale or lucal la�v regulafirg construcfion er fhe <br /> peAormance o/constn�cfion. That I am authoiized by the on�ner ol this properiy to perfonn Ihe <br /> work Ior wlrich applicalion is made and I comply rvilh fhe Stafe Con6actors Law 18.27 RCl4 and <br /> 296.200 WAC. <br /> , %- <br /> �� '�="< i `� "�_. %� 'i' G � <br /> Signalure/� Dale <br /> y" C4 I.�'ll�`J <br />