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ELECTRICAL PERMI i APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES u _�z..p7 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 / 07��_D �?7 <br /> 425-25�-881 U - FAX?25-257-8857—www.evereltwa.org t:- �� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> i9� �AVG ia- <br /> i 7 �5����1 I�„—:�.+--tt'C�Jt ' ��I <br /> PROJECT ADDRESS � <br /> i �' i 1 �Z�r1 I" �i�� i,l-'— I'J� S� � I�i��� cll - �� �v��I�tf ���./ � � l;�.i�{ I D.�� �(�rU -7�(�� � 1�%jl1 <br /> Owner Mail Addmss City StalelZip Phone <br /> i <br /> li�Yl.\ <br /> Tenanl MailAddress Cily �late/Zip PF.ono <br /> ( ' , i � �. �• Cr•c <br /> � ��� � I �% t �1 1 � �� �1 1 ( i � � ( 3L`.�I l_. �C�Ik�� Y-�t �; i+ii��� w�1 �i�C� 7 � `-f�5� Is� L��,u <br /> Eleclrieal CoNraclor Mail Addmss City Stale/Zip Phonz <br /> I ILL I G`��J �J(�� �1L�L l:��'�� � �L� � <br /> Slale License Number Conlrect Price of Work <br /> ��'�(:'-�--� �>G-CE�i��� Ct. <br /> Proposed Use o(Building Contacl Person (Plan Review) <br /> Descriplion of Work lo Be Dona ���� I�� �,��.�ti'.i C '.[.L�� <br /> � � <br /> NOTE: WIRING IN NON-DN'ELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby:eCily that I have m.ad and examined this application and know fhe same lo be frue and <br /> correcf. AI!provisions ollaws and ordinances governing fhis type oI work will be complefed <br /> whether s:eci�ed herein or noL The granfing o/a permrt does naf presume(o give authonty to <br /> vialate or cancel(he provisions ol any other state ar local law regulafing consf�uction or the <br /> peAormance ol constnicGon. That 1 arn au(honzed Gy the owne�o(fhis property to peAorm the <br /> work(or�vhich applicafion is made and 1 comply with the State Contracfors Law 78.27 kCW and <br /> 296.200 WAC. <br /> i <br /> �+ - 1 � <br /> � <br /> , Z � .S� - � <br /> SignaWrc . �� Date /// /1 � <br /> r /)��� <br /> l <br />