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ELE�TR;�AL PERMIT Af�PLICATION <br /> CITY vF FVERETT PERMIT SERVIGES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS AkE ACCEPTED FRUM 8 AM TO�{ PM <br /> _ ',i:-- :.�, - <br /> '�l'�i" _�l `x_ -r vr v�-(�� � ��r� ` i�,ZC,� <br /> PROJECT ADDRESS <br /> �, , r �1C;� <br /> -�.-' �ri..b. Y�� l. �� � i�-/ I � � �c� L�,��a,� �� `'�� ��.G.l�i"�� �.�/� `/`CLO'.77 ��l�.�c,O�o <br /> Owner , � Mail Address City Stale/Zip Phone <br /> Tenant fdail Address Cily 51ate/Zip Phone <br /> Electrical Conlraclor Mail Address Clty StateiZip Phone <br /> Stale License Number Contracl Price o(Work <br /> Proposed Use of Buildinc� Contacl Person (Plan Review) <br /> / <br /> Descriplion of VYork to �e Done: �� �'[��(_L�� <br />.� <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIREC TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I he�eby certil}�Ihat 1 have�ead and exarnined fhis application and know fhe same lo be true and .- <br /> correcL All p�avisions ollaws and ordinancvs govermng this type ol work will6e cornpleted �(,ZQ(��� - �)��U <br /> whether speaGed herein or noL The granting ol a pernuf does not �resume to give aufhorrty fo <br /> violate or can�el the provisions of any other slafe or local la�v iegulatinc�construcfion or fhe <br /> perlonnam:e o�constnicfion. That 1 am aufhonzed by Ihe owner oI fhis property to peAorm fhe <br /> woi.4 Ior which application is made and 1 comply wifh Ihe Sfafe Contractors Law 18.2?RCW and <br /> 296.ZC0 WAC. <br /> � <br /> �.%',=i � <br /> � <br /> _- 1�1-�..._/�,,_ f�'1 �L�� . . ��� � i-Y�-�1t� — — <br /> Sign�ire� �� j Date <br /> L� <br />