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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEGAR STREET, EVERETT, WP. 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org �_ � L��„� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> i=p �`�—�OS <br /> � � rtil C � � � <br /> �� L I 1 ( �'�D � !v l��V c_ <br /> PROJECT ADDRESS �- <br /> / GcXc-7/�- )i�f <br /> ���_cK I�ti�C.,��Jl�rlv�•.t-1 �( 2 E�� TI-�U)ti�S��J l�U� �i/�kE �i ��� �ZO� <br /> Owne� M11ail Addiess City Slatc2ip Phone <br /> .��/A <br /> Tenanl Mail Address City SlatelZip Phone <br /> �VofU��( /ZzUi 2 fCfC�ZZC �U Is�y 1�Z3 .S-w�cnuc5� �J�4 9��5� `�ZS-3Z7-� 7 <br /> EICCUical Conlractor ldail Address City StatelZip Phone <br /> IVv12T/.If_'t i�.,1J 5 c�oc: '•` <br /> Stale License Nurnber Conlract Pnce of Work <br /> (�45r nFN- ..-n � <br /> ProposeA Use of Duildin�� Contact Person (Plan Revie�v) <br /> Descriplionof Workto�oDone: ti= ��` /��� � i �, ; C r .2c��- <br /> NOTE: WIRING IN NON-DWELLINGS IS R[QUIRED TO FEE <br /> BE IN RACEWAYS. A1C OR AC CABLE. <br /> CITY OF EVERETT LOCAL SAL[S TAX CODE IS 3105 <br /> � �/ <br /> I hereby certdy that!have read anA examined thls applicalion and kno�v the sanre(o be frue and �.�_1i�' � � � <br /> cnnect All provisions o!la�vs and ordinances govenung this type o/�rork�vill be cornpleted ( � <br /> �vhefher specilied herein or noL The granfing o/a pernnf Aoes not presume to give aufhority to <br /> ��iolale oi cancel Ihe provisions ol any olher state or/ecal la���regulating consfiucfion or fhe <br /> perfonnance ol construction. Ti�at I am aulhorized by fhe o�wier o/this property to perform the <br /> woik Por�rhich applicalion is made and 1 comply with Ihe State Confracfors Law 7827 RCW and I <br /> 296100 WAC. <br /> �"� <br /> I --�-��� ->-Z 2-!��`�' <br /> � � S�gr,;alure Date <br /> I <br /> i . . . . .. . .._. _ . _ . . _.. . ._.__ __.____-_— <br />