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I <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES S,�g..{a <br /> 3200 CEUAR STREET, EVERETT, WA 98201 � <br /> 425-257-8810 - FAX425-257-8857-www.everettwa.org ��-�v,s � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 2��� WL�C ;^.�D��� <br /> PROJECT ADDRESS <br /> ����� � <br /> �nfJPl �iUece� l�- A. <br /> Owner Mail Addross Clty S1ate2ip Phone <br /> Tenanl Mail Address Gb Sta�elZiP G ph�e- <br /> fL <br /> � A. 9c�diZ d"�"�3yc <br /> AIl CD�nI�`I �- l��i�'IG 1��; �f�; A�� .�E � 3��.p�� ,�, <br /> Electrical Conlraclor Mail Address City Slale2lp Phone <br /> A�� cocc 40 � �G ��y3o � <br /> Slale Lfcense Number Co rect Price of Work <br /> Proposed�o�ing Conlact Person (Plan Revlew) <br /> Descriplion of Woric to Be Done: f �^ �l U � C�Iit7��O N S — <br /> � � � ���O <br /> � <br /> NOTE: WIRING IN NON-DWEILINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. ��. �J <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �" `�� <br /> 1 hereby certily that 1 have read end exemined fhis application and know the same to 6e true and `=�7�✓— �� <br /> correct. All proNslons o/laws end ordinances goveming this rype of work wlll be comp/efed <br /> whether specified herein or not. The granfing of a ponnit does not presume fo give authority to <br /> violafo or r.ancel fhe provisions olany other sta(e or local law regulafing consfruction or fhe <br /> perfortnanc o/consiruction. That 1 am authonzed by the owner o/lhis property to perlonn the <br /> - -work-/a• alrepplicetion ism de end l complywith�fhe-StateGontracf�rsEawd&2FR6W-end <br /> 296.200 r4C. <br /> � � ��o_ l7� <br /> Signa ure Date <br />