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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT', WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� � ��- `xj N1 f�)1 T��U�' <br />PROJECT ADDRESS <br />l�I�A�Y i,Y <�.��, <br />Owner Mail Addross <br />Teoanl <br />M11ail Address <br />City <br />City <br />�l -S�/t_'� <br />C-1DIi��� <br />State2lp Phone <br />� LJ J���25 l <br />S�ale2ip Phonv <br />;��rr��,'1 i-r ��:1�i �c. I;�1 c � ��>; '��, Isr S� N ��J '��-r� N��� p�,�, \`�� .9 2 <br />EleClfiCal Conlraclor Mall Addmss City State2ip Phone <br />Surs,i�i•,�r:l c�r��:� i�"Z <br />Stalo License Number <br />5.i". � _ <br />Proposed Use al Building <br />��. J���� <br />Conlract Prico o( Work <br />Contact Person (Plan Roview) <br />Descriplion of Work la Oo Dono: LJi �(_� fJi_ �J S I�. �. �,��1 /�N��� �'%U�.t— I� tnU <br />NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO <br />13E IN RACEWAYS, MC OR AC CABL6. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cr.rtily fhat 1 Oave read and exantined Ihis application and kno�v (he s:�me fo be Vue and <br />corrr.eL All provisions o/la�vs and ordir.arces govemmc� f/�rs fype ol mork will Ge cornpleted <br />u�hefher specdied herein or noL Thc grarting ol a pernu( does nof �resurne to give authonly fo <br />violate o� cancel (he Iv�ovisions ol �ny ofher sfafe a focal law rec�ulafing construction or fhe <br />pe�fonnance o( cautruction. Thaf I am aufhorized by the owner ol fhis property to pedonn the <br />n�ork !or irhidr applicafion is made nnd I compl}� �rith fho Stafe Cont�actors Law 1827 RCLN and <br />29G.200 WAC. <br />� <br />i <br />_ 1 <br />�.,,_ --___, " i � - i <br />Si�naWre Dale <br />FEE <br />E ����-c�-�r <br />