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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �_zz-�/ <br /> 3200 CED�+R STREET, EVERETT, WA 98201 <br /> 425-25'-8810 - FAX 425-257-8857 —wvwv.everettwa.org C��l��"�y <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � �( / <br /> ,� � � �3 � �'-�--- <br /> PROJECT ADDRESS <br /> "��—_— <br /> ����� ! � ���—// <br /> _ _ Y <br /> Owner <br /> Mail Addrass Cily State2ip Phone <br /> ��t���';��� ,�/� /` � _ <br /> � Mail Address T--_ City State/Zip Phone <br /> Tenant <br /> ..�1.�J. 1=G�� 7-�� �c � � L�� ���'S� ` _ ��l - <br /> Electrical Cuntractor M1ai1 Address City Staterzip •��/_ �� �hoPe6 S <br /> ��<-+�' O ! <br /> //� �I �'"'�! G ���' '� Contract Price o� <br /> Slale License Number <br /> � 1 r <br /> Proposed Use of Building Contact Person (Plan Review) <br /> /� l i � <br /> Description of Work to �e Done: �L�� �� _.-� ' G—� <br /> r�i��.�/�/I�/f��la�/" �' Sf,� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> B� IN RACEWAYS, MC OR AC CABLE. <br /> � CITY OF EVERETT LCCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi(y(haI I have read and examined this application and know Ihe sarne fo be true and .� `i c,�� — I y �I <br /> correcf. All provisons o!laws and ordinances governmg this type of work will be completed <br /> whether specilied herein or not The pranfing of a pennd does not presume te give aufhonty fo <br /> violate or cancel ihe provisions o�any ofher state or locallaw regulating construction orthe <br /> per(ormance o(construction. That I am authodzed by the owner of this properiy to pedomi the <br /> wortc lor which application is made and 1 comply with the State Confracrors Law 18.27 RCW and <br /> 296.200 WAC. <br /> / / �--'--T <br /> � ���� ��� �� D2te <br /> SignaWre /� <br /> _� <br />