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ELECTRICAL PEh2MIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 – www.everettwa.org <br />APPLICATInNS ARE ACCEPTED FROM S AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />-Ga�� ,�� S i <br />PROJECT ADpRESS <br />�� � U / i'� � Sff u� <br />Owner <br />N�N� <br />Tenant <br />2 0 �� 3S"'D ST <br />Mail Address <br />Mail Address <br />L ✓ G�/�L.%/ <br />City <br />City <br />G�� <br />SWte21p <br />State/Zip <br />Phone <br />Phone <br />%Frf� f"L�cj�C'�c Qo g�k /��? �i�o�L^�,o��s/1 //�%� /�z9/ 3Lo ),i rz97 <br />Electrical Contraclor Mail Address City State2ip Phone <br />T'�fy-� �E�q7Zlh :9 <br />State License Number <br />/�i�s i I� R=t�Gi� <br />Proposed Use of Building <br />�/ gvo-= <br />Contract Price of Work <br />Co�tact Person (Plan Review) <br />Description of Work to Be Done: ���L�"c � �X i t�/ n/6- Z/n s� o PA-N�L <br />A N � � � �� v �� ,s�_H-i..a � 5,�2 � � �,� w / /�/,��+.� . <br />1 Z�o � MiA� <br />NOTE: WIRING IN NGN-DWELLiNGS IS REQUIRED TU <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />FEE <br />SS� <br />1 hereby certify that I have read and examined this applicafion and know the same to 6e true and <br />coirect. All provisions of laws and ordinances governing this fype of work will 6e completed <br />whether speci�ed herein or not The granting o/ a permit does not presume to give authonty to <br />violate or cancel the provisions o(any other state or/ocal law regulating consWcfion or the <br />perlormance ol construction. That 1 am authonzed by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />C'��—� /D- z� ` pc�` <br />Cr�ll G - �3�� <br />