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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 S _f 4�p� <br /> 425-257-8810 - FAX 425-257-8857 —evww.everetP�va.org <br /> ��goS--o� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> `J.����r.+- � �C�`� �l" ��;c��C� n1 <br /> PROJECT ADDRESS <br /> C>Wn�,r 1.1dJivl.lrc',': � ��l;ii� St.ilr�q� �_' Phnn�, <br /> _ __"_._— _- _— — _ .—_ —_ <br /> T�Cll,llll I.i.W lvlqrn.q�, <.�I� n:,dr-.'.ip Rh��nn <br /> ��t(t..��- Cl,c�z . I�l�ns�,1�,,�_ST slr �Su.� �A ��oZ�v Z�S�� �b <br /> Electrical Conlraclor Maii Addiess City StalerZip Phone <br /> ��C..'t"(�J. ��.�.�� . -, � ' ; <br /> State Licensc Numbvr Contrac Price o(lNorF: <br /> 4��-���`.:CL�I�'.'�c.��—Y (�,l ,� --- <br /> Propdsed Usc o1 Guildln� Con�act Pcrson (Pian Review) <br /> � T � � <br /> Desoription ol Woik to E3e I7une: ��—1 lI' � \� L� � \ � ��'����V�� �= �.`L�,�ti� _ <br /> ! <` „�'I S' - LJ �� � � s' -- <br /> /"�`Li�L��- IYJ ��� �.C-'� `'y <br /> �T r I <br /> NOTE: WIRING IN NON•DW[LLINGS IS RE�UIR[D TO FE[ <br /> B[ IN RACEWAYS, A1C OR AC CADLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceiiily fhaf 1 have read and examined this applicafion and krrow the same(o be true and <br /> aorrecL All provisions olla�vs and ordinnnces gevemin�(bis fype oI�rork�vill he completcd <br /> rvhether specilied herein or not. The gran�inp o!a permd does not �resume to gi��e authorify�fo <br /> violafe or cancel(he provisions ol anv other sfafe or Iecal lan�regulatiny construcfion or fhe <br /> perfornrar e o)c frticfion. Thal I am aufhorized by fhe o�rne�o(this property fo perform Ihe � /� <br /> �t�urk Ior��ich a pl cafion is made and 1 comply wifh Ihe Sfafe Confraclors Law 78.27 RCIN and !� <br /> 2J�.200 NAC. � /� :��.� � <br /> � � � L\ � <br /> ; � - 1 �1 — c� (� <br /> Sign iwa } Uate <br /> I � <br /> � ; <br /> i <br /> � / <br /> I <br />