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ELECT�RICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 7 ��6 � � <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org ��6� <br /> bogo <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> -. ,, �� <br /> �� C�'.J�� � .�'�l�'C� ��' �� <br /> PROJECT ADDRESS <br /> `1 <br /> t�C,���r � 1�U.�,��� L.\ \L. � ���1 �—� IG� ' � 5(UCJ <br /> Owner Mail Address City State/Zip Phone <br /> Tenanl hlail Address Cily State/Zip Phone <br /> �U..L-��1�� \�.. � �.. -> , i �C <br /> � ��L-�.�11��, A� � � l/� � L�Z�'1 �—Flc� �_� � 1 �' <br /> Eleclrical Contraclor �fail Address City State/Zip Phone <br /> � ��. <br /> ����c �-��r-N�c�C��� � �J;S �;II � — <br /> State License Number Contract Price of Work <br /> Proposed Use o(Building Contacl Person (Plan Review) <br /> Description of Work lo Oe Done: �� �V � �,�-� ��� �� �� � <br /> NOTE: WIRING IN IJON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ��y`�-� ��1� <br /> 1 hereby certily that I have read and examined this application and kno�r the sarne to be true and <br /> correcL All provisions olla�vs and ordinances goveming this type o/work will be cemplefed <br /> � <br /> whether speaGed Ferein or noL The granting oI a pernut dues nof presume to gi��e aufhonty fo <br /> I violate or cancel the pruvisions ol any other state or local law regu/ating construction or the <br /> pertormance ol construction. That I am authonzed by the ouner ol this property to per(orm the <br /> �vork fer�vhich applicafion is made and 1 comply�vith the Stafe Contracfors Law 1827 RCIh�and <br /> 29G.200 WAC. <br /> � � ' I l,� � oE,' <br /> � ' ., / i; '��--_� � _ <br /> " Signature� Dat <br />