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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 �EDAP STREET, EVERETT, WA 96201 / a ��.�� <br /> 425-257-8810 - FAX 425-257-8657—www.everettwa.org <br /> C 7i-z�I a-6 <br /> APPLICATICNS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �g�l ���u�r F!� , C�Q,c�,({-G.Y-t ��a� � <br /> PROJECT ADDRESS <br /> Owner tdailAtldress Gty S1ate2ip Phone <br /> ���t��,� Cc�o �B-al 2�nu.cs�f (}.1Q- �1R�`kf� (r��'�i�' �3 bI <br /> Tenant Idail Atldress City State2ip Pnone <br /> �E2S <br /> .�-euefzs.i,�s ,�1� .�e✓�r�r� Wu �,n�r�l�- ta�9-�IF�o f -��`2-.a� <br /> Electrical Contrar.tor Mail Address Cily State2ip Phone <br /> �C--�V��\'� 9�—�t-� � � �'!'�� • �Ofl <br /> State License Number CoMrect Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description ot Work to Be Done� ���`�I1Gt��'� ��"' ��Gf� �1�J�-� rl <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 /> I hereGy cerfily fhaf I have read and examined this application and know the samu fo be Irue and <br /> conecf. All provisions ollaws and o�dinances govemrng(h�s type of�voik will be complefed <br /> whefher specilied herein or noL The granfing o/a pennrt doc-5 not resume!o give aufhonty fo <br /> violafe or cancel fhe provisions ol any other slafe or local!aw mguPting consfmction or Ihe <br /> pedom�ance ol consiruclion. 7haf 1 am aulhonzed b}�fhe owner ol fhis propeRy fo peAorm Ihe <br /> �:ork Ior which applicafion is made and I compty with Ihe Sfate Confracfors Law f 827 RCW and <br /> 296 �0 KA . <br /> � (2-�� I ��x� � � �; <br /> Sig Wre Da e - �� .�� <br /> � <br />