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r <br /> ELECTRIGAL PERNIIT APPLICATION <br /> C1TY UF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREiT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I%:-� i•i r � �-� � v�= �v � (�<< ;�,� , ; <br /> PROJECT ADDRESS <br /> �/' C�c ��;�' ��i�ri ����i�.�s�- / —�/ZfrLi//�� �� `-�4'ztf) � s�:^, �CS3 - l5'8� <br /> Owner M11ail Address City SlatelZip Phone <br /> Tenant Mail Address Ciry SlatelZip Fhone <br /> �cu�u�� �.,Zc � - /�� i3ot ���� �-ti�i�irVd/� lU� `�8�7c� ���c� �'7e �3 �0 <br /> Eleclrical ConlraCtor Mai�Address C�ty StatelZip Phone <br /> � <br /> L �iIJlvE`X c-� � �'�/��3 <br /> Slale License Number Conlract Price of Work <br /> � �` � <br /> Proposed Use of Building Contact Person (Plan Review) <br /> , . / � �. <br /> Description of Work to Be Done: ;��[+�V � 5 5 j SC' ��_ (�'(��E �l �!/r�-'U <br /> NOTE: WIRING IN NON-D`NELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi�y fhat I have read and examined fhis applicalion and know the same to ue true and <br /> correcL All provisions o(laws and ordinances govemmg this type o(work will be con;pleted I <br /> whefher specilied herein or noL The granting ola permd does not resume to give authonry to <br /> vielafe or cancel the provisions ol any other state or local law reguPfing construchon or ihe <br /> perlormance otconsfruchon. That 1 am authorized by fhe ownerolthis property to peAorm the <br /> work lor�vhich applicafion is made and I comply�vith the Stata Coniractors La�v 18.27 RC W and <br /> 296.200 WAC. � <br /> � � .�-�- j (- 25- C^�� <br /> ' Sic�nature ` Date <br /> j=Vc�'!� 'f��1 <br />