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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �_ � �_�i <br /> 3200 CEDAR STREET, EVEI:EIT, WA 98201 ���p( _I V� <br /> 425-257-8810 - FAX 425-257-8857–www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> IC� 31 P��c.�.e r- lt1 �e- k.lece.�?,- ��Z.o � <br /> PROJECT ADDRESS <br /> ���_C,ull Oc �, <br /> � ZOb �I`�}- 12 <br /> OWner Mall Addross Cily State/Zip Phone <br /> Tenanl Mail Address City Stab/Zip Phone <br /> �M a 1�.��t��,c� Pc���x �c� �> ��Q �ttr Wc� ��s� e <br /> Eleclri al Contraclor Mail Address City Stale2ip Phone <br /> r � � # wunP �a ��v� �o�o �-I �oo. oc� <br /> Slale Liconse Number Contract Price of Work <br /> Proposed Usct of Building Contact Person (Plan Review) <br /> Description of Work to Do Done: ��Q W L� �J [ j r VI� �O� GtO�S <br /> � <br /> �Cl�kni 7f — <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CADLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 31Q5 �- <br /> I hereb}�cerii/}�fhaf 1 have reaAnnd exernined fhis applicefiori and kno�v the same fo be fn�e nnd � i 1 Ol� - I 3l <br /> con�ecL All pro��isions o/laws and ordinances governmc�fhis t}�po o!tvork will Ge complefed <br /> �rhefher speaGed herein or'noL The�i.�nfing ol n pennd does nof �rosume fo give authonl}�fo <br /> violafeorcancelfhe �rovisionsolanyotherstafeorlocollawre�ulafingconsWcfionorlhe <br /> perlormance o/consliucfion. That 1 am authoiized by fhe owner ol fh�s�roperty to perfoim fhe <br /> tvark lor�rhich applicafion is rrtade and I comply�rith fhe Sfate Conlrectors Law 18.27 RCW and <br /> 29G.200 WAC. <br /> -� ` ; <br /> c�r� � ���� i"'�- � � _ � � <br /> �SignaWre Date� <br />