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ELECTRICAL P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-885/ —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> >> �- I U �IVAVt- 1�4cI�IL <br /> PROJECT ADDRESS � <br /> J ��v'�TI� -`�M� ��v�.R�=.i I <br /> Owner Mail Atldress City Stale/Zip Phone <br /> Tenant tv+ail Address Cily Slale2ip Phone <br /> �� EfL�.It�1C� �-�E_�=7R-1�-. 1�3C . �U �'�O�( L�I-�1 �oo��i�IJi�LL-. WA �i�l,v��2 <br /> � <br /> Eleclrical Conlraclor Mail Ad ress /,% �7ty State/2ip Phone <br /> �, n / �z<'' 9�`L� 91Z2. <br /> `�I EIZLEI�S ILI-I ' � '�(t C{ JJ — <br /> Stale License Number Contract Price of Work <br /> �X���t, �l fZ <br /> Proposed Use of Building Contac�Person (Plan Review) <br /> DescriplionofWorktoBeDone: LI/�IZJ�C-5G ��J�I.,l�S ROpT1 /1'DO ITIbN <br /> 1`10�/� F_XI IlrlC c�J /JI'�1' YI�.T�{Z P�I�S� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIR[D TO FEE � <br /> BE IN RACEWAYS, MC OR AC CABLE. � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I lrereby ceRily that I have read ond erarnined this ap��licalion and 4now fhe same lo be f�ue end <br /> conecL All provisions olla�vs and ordinances governin�this type o/work will be complefed <br /> whefher specdied herein or noL The,qranfing ol a permd does not �resume!c give authority fo <br /> violafe or cancc!llre provisions o!an}�ofher siale or local law reyu�ating consfrucfion or the <br /> peNormance ol construcbon. T'hat I am authorized hy fhe owner o/fhis property lu perlorm the <br /> work lor which application is made and 1 cornply wi(h fhe State Contracto�s Law f8.27 RCW and <br /> 296.200 6l�AC. <br /> - C ' - � '� I f�`-� <br /> SignaWre � Dale <br /> � � <br /> � <br /> �/� •/ � �i� <br />