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ELECTRICAL PERMfT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 ANI TO 4 PM <br /> �� � `� � �' C � � ��, /�" _— <br /> i ���1 t �'--p-�= �v <br /> PRUJECT ADDRESS <br /> �ync��l-�., ��>>uS (�G (�ox �(� w'i,�c�, ��;n R��c� `/2s 2s� s'C s°i <br /> OWnef MailAddress Cily Slale2lp Phone <br /> Tenanl A9ail Address City State2ip Phone <br /> ' N-%ti� �,CrtTA-tC S71N y�'''191�� ti� �k' S��=ns C���2 9a'.?s"'a' �JZS' �3S7b�^o <br /> Elecirical Contracbr Mail Address City Slate2ip Phone <br /> ��h�t'���iy�P1�G- ,� �do. �, <br /> Slate License Nurr.L�ar Conlracl Pricct of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Wark to�e Done: ����� I�«�< <"�^f����'`�7 ��'���� l�d��' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily thaf I have read and examined Ihis applicafion and know fhe same fo be frue and <br /> correcf. All provisiais ollaws ond ordinances govenung fPos type of work will be complefed <br /> whether specdied harein or noL The gr�ntin�ol a pemuf does not resume fo give aulhonty to <br /> t�iolafe er cancel Ihe r�rovisiens ol any ofhersfate orloca/law reguPting consWction or the <br /> peAormance olconsfiuc(ion. Thaf I am au(horized by Ihe owner o/fhis property fo perfonn fhe <br /> work lor which epp�ication is made and 1 comply wifh Ihe State Contraclors Law 78.27 RCW and <br /> 296.200 WAC. <br /> % <br /> • / n <br /> ( / t.. <•u�� � -'/ ) —6'� <br /> Sign lu�e Date <br /> � GCcU� -G�j� <br />