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ELECTF�ICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �? <br /> 3200 CEDAR STREET, EVERETT, WA 98201 2 —�J --� /,� r� <br /> 425-257-8810 - FAX 425-257•8857 -www.everettwa.org �' p gvZ—a dZ� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> . � <br /> ' ; ( ���, , �l � ,�� ��j ,�� � f�'�-��� <br /> PROJECT ADDRESS <br /> � <br /> ` !.� �,^, �� �_ ,_„'� ..,^`�.` - <br /> Owner� h�ail Addmss City SI�le2ip Phone <br /> ��� <br /> Ten' t Mail Address Cily StatelZip Phone <br /> 7 (�v <br /> 1����C'�F� 1'V` V L� .l�l, ���1C,�1 (: `( ti� �T�- \1��� _ l. �/�!�(C�C`�t � Z�-�i II`L�, <br /> Eleclrical ConUaclor Mail Address City StatNZip Phone <br /> �.A A 1i .c ,�l `'"��.�(��c��� �� �4.���� <br /> Slate License Number Contract Price of Work <br /> �� l.� � 1 � ` � I�,�' (� �:���1 �� ��, ���til <br /> Proposed Use of Buildinc� Conlacl Person (Plan Review) <br /> Descriplion of Work lo Be Done: ��,L\.� C1� �' � ' � <br /> NOTE: WIRING IN NON-DJv[LLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVFRETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hercby cerlity fhat 1 have read and exarnined Ihis application and know fhe sarne to be true and <br /> conecl. A!I provisions o/laws and ordinances governing this f}�pe o/�sod;�ti•ill be complefed <br /> whefher specrlied he�ein or noL The granfing of a pernuf does not presume to give authonty to <br /> violate or cancel the provisions ol any ofher sfate or local law re9ulafing construcfion or the <br /> peilorrnance oI cons6uc6on. That I am aidhorized by the o�rner o/this propert}�to perform fhe <br /> �roik Ior which epplication is made and I cornply wifh fhe Stafe Contraclors La�v 1f3.27 RCl1'dnA <br /> �96.200 WAC. <br /> � �� �� �� <br /> i _ �_ � �� - ' <br /> , <br /> Sr.indluie Delc ��� �� JG�, <br />