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i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi, WA 982G1 2 � I�l D <br /> 425-257-8t310 - FAX 425-257-8857—www.everettwa.org ��06 Z�p6 <br /> APPLICATIONS ARE ACCEPTED FROM tl AM TO 4 PM <br /> �g�/ � �' '�� D�' !�/ <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> r;;����' / ���1_� ��� <br /> Ten:.... Mail Address City Stale/Zip Phune <br /> l�'ZB/'t7� �L.eGf/'iCZNc 1220/ CYk�s wni .1'tr� �U�.ffeo �GSh �427,� �rr�3�S•S'(j <br /> Eledrical Conlraclor Mail Address Cily StatelZip �Phore <br /> .�_ /43, OD� <br /> Slate License Number Cbnlract Price of Wbrk <br /> Proposed Use o(Building Contacl Person (Plan Review) <br /> Description o(Work to 6e Dona ! � <br /> �� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> 1�����.. <br /> CITY OF EVERE77 LOCAL SALES TAX CODE IS 3105 <br /> /hereby certily that 1 have read and examined this applicafion c�nd know fhe sarne to be(rue and <br /> correcL All provisions o(laws and ordin�nces gevernina this type o/work will be complefed <br /> whether specified herein or noL 7he�ranting o(a pernut does not presume fo give aufhonty fo <br /> violafe or cancel fhe pro��isions ol any other stafe or local low regulating wnsfruction or the <br /> perfonnance o(conslruc(ion. 7'hat 1 arn authonzed by the owner o(fhis property fo perform fhe J <br /> work lor which application is made and 1 cornply�vith fhe State Contract�rs Law 18.27 RCW and _ U�li; <br /> zss.zoo w.ac. _ h�� <br /> —,�_Y l� <br /> i�i�i��. . <br /> Siyny� Date <br />