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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES r� _� y_D� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org , ���7�� _Q�q' <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> / ) �� I�VCT �'�7 � 12-l� /� V� <br /> PROJECT ADDRESS <br /> Owner Mail Address City State2ip Phone <br /> Tenant Mail Address City Stale2ip Phone <br /> �J � �l �LCLT/'�-i-�- I'.0 j'�ox Z)�7 Ly.vn�. l,�,q yf�jC L/LS-7's1-7!S <br /> Gec�rical Contraclor Mail Address City � SlatelZip Phone <br /> ' (��7 <br /> �h L �E 1�E �l �c/;/i � fTon x..e <br /> Slale I.icense Number Contracl Price of Work <br /> I`��7 L 1)�rI.GY ��AN n�' <br /> Proposed Use of Buildinc� Contact Person (Plan Review) <br /> Description of Work lo Be Done: 1G f-/��,.`�1�L.� A n o M I� 7�.�� (J�7�'1 /�UG+NI <br /> � n �MG /�,eC� Mn-Srr2 1�i/�/Z�cM . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABL[. <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br /> I he�eby certily fhaf I have read and examined fhis applicafion and know Ihe smno fo bo We nnd <br /> eorrect All provisions o(/aws and ordinances e�overnmg fh�s lype ol work will be completed <br /> whelher speci�ed herein or not The grnnfing o!a pemul does nof presunte to give aufhonty lo <br /> vialafe or cancel 17�c provisions o(any ofher sfafe or local law regulafing consfruclion or fhe <br /> peiformance o/construction. Tbal 1 am authonzed Gv fhe owner o/(h�s properiy to peifomt the <br /> work lor which applicafion is made and I conrply willi Ihe Slale Confiacfors Law 78.27 RCW and <br /> 296.200 WAC. � /j <br /> � ��� � <br /> � / 11-J�- o�� <br /> ✓ Signalure /' Date <br /> � <br />