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- --� � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVFRETT, WA 98201 �_.� S�� <br /> 425-257-0810 - FAX 425-257-8857 —v,vrw.everetlw�.org �v 6 0 c�- D6,ti <br /> d <br /> � APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> cr l PGI� r � e , - <br /> �'_.. I` ( % � (,' �i,f � � � �� �- � t <br /> PROJECT ADDRESS � (� <br /> ) <br /> � <br /> , ? , , � ' f�v� ' <br /> �� �, r � ��� <br /> Owner � il Address Cily SWte2ip Phon^ <br /> Tenanl Mail Address City Slate/Zip Phvne <br /> [leclrical Contractor Maii Address Ciry State2ip Phone <br /> Slate Licanso Number r� Contrar.� Pric�o�WorF: <br /> i <br /> r' } � <br /> �L� �n � � t:t.t2r � '" l �� � -- — <br /> Propused Us of$uildin ° Cont;�c� Person �Plnn Revicw) <br /> �� i <br /> Description of Work lo De Done: �2� � -� = 7'C'i✓�t 1 �-� C -- <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 /> 1 hereby certily fhat 1 have read and examined this application and know the sama fo be t�de and -� - � �- � �`- <br /> correcL AI!provisions ol laws and ordinances govemmg ihis f}�pe o/work will be completed <br /> whefher speci(ied herein or noL The granting o!a permd does nof resume fo give aufhorify!o <br /> violafe or cancel Ihe provisions o/an}�other stafe or lucal law reguPting construcbon or fhe <br /> perlomrence oiconslniction. rhaf I am authorizeAby Ihe owner o/fhis praperty to periorm Ihe. <br /> �vork!or which applicafion is madr and 1 cumply u�ifh fhe Sfate Centractas La�v 18.27 RCIN mid <br /> zsG.zoo wac. � <br /> � <br /> .i—�" � <br /> i-�> (,` <br /> � Sipnature Ua1e <br />