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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-3810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I <br /> llo I i� 1 �1 � 1� 1'� V � n �� c <br /> PROJECT ADDRESS <br /> L 1 /�(i.lf I�l � �Y� _ <br /> O'.vner L1aIl htldress Cit, State2ip Phone <br /> Tenant Mail Address City SlatelZip Phone <br /> 51�F� 7- hnclu � Cx �o%.`�o:; Nt i�w �'19 S.. c. G #`3�7S�Vu,lc.o�ws uiA 9B�6S/34o-�`15 3° <br /> ElCclrical CoNrac�or Mail Address Ciry State2ip Phone <br /> 51� �� "� T C� `1 '!°l(�I-1 �IU , o`�O <br /> Sta�e License Numbei Contract Price of Work <br /> C� � �1 � s S �- -L;r C .. r l�c�G S�w -� v f' <br /> Proposed Use of Buildiny Contact Person (Plan Review) <br /> Description of Work to f3c Done: i� -1 � v �� c � S f�. nk< � 5 <br /> NOTE: W IRING IN NON-DW ELLINGS IS REQUIRED TO FEF <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX COGE IS 3105 <br /> 1 hereby certily fhat I have read and examined this application and kno�v fhe sarne lo be true and <br /> correcf. Al!provisions ol laws and ordinances govenung this fype o(�vork will be compleled <br /> whelher specilied herein or not. The granfing o/a permd does not resume to give aufhonty to <br /> violale or cancel fhe provisions o/any ofher sfate or local la�v reguPfing construchon or fhe <br /> performance o/const�uction. That I em auffiorized by the owner o/th�s property to perform the <br /> work for which applicafion is made and 1 cornply u�ilh the State Cuntracfors Law 78.27 RCW and � <br /> 296200 Vl'AC. <br /> I ^/�' <br /> �\ <br /> / , W <br /> ���... iiz4.'n- �c_z �� 4'� y� o � � <br /> ;/ Siflnaturc Date <br /> � <br /> �/\ <br />