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n <br />L� <br />ELECTRIC�L PERMIT APPLICATION <br />CITY OF EVERETl' PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />., <br />� �-�ii� T-v�' �-�i,�..��,� �VL� � , i(' �. <br />PROJECTADDRESS -� <br />Mail Address <br />Mail Addiess <br />City <br />L� <br />Ciry <br />UJN- `l s�c-, <br />State2ip Phono <br />I� <br />State/Lp Phone <br />�l'r-�'i��-tr�.l�Ctc���'�C. �L�LZICAI��-Gr��:a�-ti./GViY1)-k� �.��%%} `�`SZG'�1 ��-i2,`� Z`�'��-'>�, <br />EleCtriCal Contractor Mail Address City � Slate/Zip Phone <br />`�r',t•., l"C—l= X 211 fU�F� <br />SEate License Number <br />i������r;�,���� �=�<< ��,1;�1�, <br />Praposed Use of Building ! <br />�F� �{ �IUIG • `� <br />Contract Price of Work <br />�" �� <br />vv[il.'��1�' L.�l �L_U�li_� t�..i <br />Contact Pe on (Plan Review) <br />Description of Work to Be Done: ` V�'�� � 71 1�( �� � 1(' 1 l ('- � C� � C L� � � �� t`U� �- <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CI iY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />I hereby certi(y fhat l,iave read and examined fhis application and know the s� <br />correct All provisions ollaws and ordinances goveming this type of work will � <br />whelherspecified herein ornoL The granfing o�a permd does not presume to <br />violate orcancel fhe provisions o/anyothersfate or/ocallaw regulafing consh <br />perlormance olconsfruction. That I am authonzed by Ihe owne�o�this proper <br />work lor w.hich application is made and I comply with Ihe Sfafe Conf2ctors Lai <br />296.200 WAC. <br />�_J, , • <br />—YJ:'! .z;'J.-% �r?f-c"�( ��_� �i � I�D IL5 <br />/ 5� �ate <br />to 6e true and <br />ompleted <br />a authonty to <br />and <br />FEE <br />