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ELECT''.ICAL PERMIT APF''_ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.o�g <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> , , ,� i' <br /> ��c-''J _) /-�' ✓-�"�S i r� c 'i <br /> PROJECT ADDRESS " <br /> � ` � ' - - --- <br /> Owner A1ail Addmss Ciq State2ip Phone <br /> � .�LLAt� .�( Ji:.'� �i� _ <br /> Tenant Mail Address City Slate2ip Phone <br /> �—� � � �-��=r� C� <br /> Elecirical Conlracbr Mail Address Ciry State2ip Phone <br /> State License Number Contract Price of N'ork <br /> �.J�--�-, <-�- <br /> Proposed Use of Building Conlact Person (Plan Raview) <br /> � � <br /> Dcscription of Work lo Bc Done: �— �� ��2 i__ _ <br /> NOTE: WIRING IN NON-UINELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereh}�certily fhat I have read and examined lhis application nnd kno�r fhe same to be frue and <br /> conecf. All provisions of lau�s and ordinances govenung fhis type ol work will be complefed <br /> �vhefher specilied herein or noL The granfing ol n pernvt does nof resume to give authonty to <br /> violafe or cancel fhe provisions o/any olher sfafe orlocal law reguPting consWchon orlhe <br /> pedommnce ol consfrucfion. Thal l am aufhonzed 6y fhe„wner ol this property fo peAonn fhe <br /> �rork Ior trhich applicalion is ntade and I comply�rifh the State Contracfors Law 78.27 RCW and <br /> 29G.200 11�AC. <br /> _ � <br /> � � �^�i�' =z� � — / 5 - t) i� <br /> 'ignalure � � � ale <br /> �� Ci�GI - D4+5 <br />