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N <br /> ELECTRICAL. �ERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, V��A 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> , . `. , � � . �, / <br /> � � <br /> �- i L� _� ��i �- L � i� � � � � <br /> PROJECT ADDRESS <br /> t�;� �, � � � , �, i � ��� � '�l � ��_ Ci.- /� �, �3 <br /> - _-5 <br /> Owner Mail Atldress City StatelZip Pbone <br /> ��_ <br /> lenanl MailAddress City StaterZip Phone <br /> ' L � l�'c�/-�L� y�� � l. �c C/.� ��� 0� />lUh�. IS�✓✓ �' L�. ��� ,?rJ3 s't�_i- SC�� I <br /> EleCtrical CoMraclof Mail qddress Ciry Slate2ip Phone <br /> ;��� � �,'vF,`i y�� �� � �,� Y s ��, _ <br /> Stale License Number Coniract Price o(Work <br /> `� - F � �7 <br /> Proposed Use o(Building CoNact Person (Plan Review) <br /> � r n <br /> �escription ol Work to Be Done: ) � L ( { � C �� _ .=(' C'— � � /S`��(� � <br /> �_.'(� ��Y F; � 7C ���� <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 31�5 <br /> I hereby cerii/}�Niaf I have read and axarnincd fHis applicafion and know Ihe same lo he hue and <br /> correcf. AI!provisions o/laws and ordinances yovernmg this type o/work will be completed <br /> �vhe(her speci(ieo hernin or noL rhe granfing ol a pernnt does not resume to give au(honty to <br /> violate or cancel the provisions o/any other sfate or local law reguPtirrg construction or fhe <br /> pe�fo�mance oI cunsVuchon. That I am aulhonzed by fhe owner ol fhis property to perlomi the <br /> �vork lor which applicafion is rnaAe and I compty�vith the Sfafe Confractors Law 18.27 RCIh'anA <br /> .'9G.200 WAC. <br /> � ;'` . � -- ..� � -�G <br /> SignaWre E l �, `� I Uale <br /> �Q I�G S-I � �. <br />